Just breathe through it- the pain will be over soon

I received my first deep tissue massage today- and apparently it was long overdue because OUCH!!! I received my first massage ever earlier this year, and I had avoided them prior to that because my back is very sensitive to touch and pressure. I, like many people, carry quite a bit of stress in my neck and upper back, and this had been a particularly stressful year- so I am all knotty. I've now embraced this treatment.

Today's session was pleasant at times but very painful at times. I knew that this current pain would ultimately benefit me so I stuck out. My mantra was:

Just breathe through it- the pain will be over soon.

I concentrated on my breathing- breathing in and exhaling deeply. I noticed that I wanted to brace myself against painful areas of the work- to hold my breath at those times.

Just breathe through it, the pain will be over soon.

I reminded myself that the current pain was temporary- momentary really. It was over almost as soon as it started. I became familiar with it which made it somewhat easier to bear.

Just breathe through it, the pain will be over soon.

After I was all done I asked my masseuse “At what point should I let you know that the pressure really hurts?” and she told me to let her know when it does. She also explained that because my last appointment was over 3 months ago we had lost a little traction- I would need to come more regularly and do some work outside of our sessions to aid in my progress. I have to make a commitment to my own healing.

My massage experience is very similar to my clients’ psychotherapy experiences, and these are the takeaway points for today:

- It feels good/ therapeutic at times, but can be very painful at times

- The intensity of the pain is a function on the depth of the injury/pain/hurt/emotion etc and the amount of prior work

- The therapy works best if the client is open/ willing to endure some pain, but should share with the therapist if the pain feels like too much.

- Remember that the pain is temporary/ momentary- healing is on the other side of the pain

- Make sure you are breathing- focus on your breath in painful/difficult times

- The therapy also works best when the client commits to regular appointments and to doing work outside of the sessions

Just breathe through it, the pain will be over soon.

-Dr. Stanley

Is your glass Half Empty or Half Full?

This past Monday was the first day of my new schedule- I now have time allocated on Monday mornings through the afternoon for administrative work for my practice. I was so happy to have time to get work done, and boy did I have a lot to do.

Around noon I received notice from a staff member at my other office location that the carpet in her office was soaking wet. Oh no! No worries, though, because I was not at the location and my office was free- she could meet with her clients there. I'd just send the landlord down to check it out. I receive a message a minute or two later informing me that the carpet in my office was also soaking wet-- double oh no! At that point I needed to go over there immediately to check out the scene.

My automatic thought at that moment: My work day has been derailed!

As I was gathering my things I found myself feeling frustrated, huffing and puffing a little and rolling my eyes to myself- this mysterious wet carpet had ruined my work day. Then I recognized these thoughts and feelings for what they were: Glass Half Empty thoughts.

I pushed myself to consider the Glass Half Full position: Thank goodness I didn't have appointments scheduled this morning (as I usually would) and that I actually have time to deal with this. Thank goodness my office was available and no appointments had to be canceled or rescheduled.

Things were not so bad after all.

I bet that most people- like myself- slide into Glass Half Empty thinking when things do not go the way we want or hope. We have thoughts like:

"This is terrible"
"Why did this have to happen"
"Things never go right"

It seems like it's much harder to look at the other, more positive ("less negative") side of the coin. It makes sense that these unexpected events cause disappointment or frustration etc., but we don't have to linger on the negative aspects or outcomes. I challenge you to explore the Glass Half Full position when you find yourself mired in the Glass Half Empty side of the situation. At the very least it will provide some balance to your thoughts and feelings about many situations that arise, and it will likely lead to some symptom relief. Some people find it helpful to write down the opposing sides and have a visual of the balance that comes when each is considered.

Happy Balancing!
Dr. Stanley

How Wide is Your Lens?

I want you to take a few moments and think about your life- as it is now.

What's going well?
What's going not as well as you had hoped?
How would you rate your life on a scale from 1 to 10 (1 = terrible, 10 = great)?

If you rated your life on the upper end, my guess is that you have a panoramic view of your life. This is a panoramic view of Seattle, Washington.

There's a lot to see in this picture. It may be difficult to focus on a single image as your eyes may be drawn to a variety of places in this picture. You may appreciate many different aspects of this view. I am personally drawn to the space needle, the clouds in the sky, and the water. This picture gives you some idea of how Seattle looks.

If you rated your life on the lower end of the scale, you likely have a narrow view of your life. Below is a picture of the Seattle Space Needle.

This picture highlights the space needle. I personally like the space needle, so this picture is pleasant to me. But if you are disinterested in the Space Needle or do not like it at all, then this picture is not so pleasant to you. And if this is all you see of Seattle and have never been, it makes it difficult to get an accurate sense of Seattle.

I believe that life is best viewed with a panoramic lens. This lens gives you a wide and balanced view of the many aspects of your life- things that are going well and things that you do not like so much. The narrow/zoom view of your life can be very limiting, especially if the focus point is a negative. If you've ever said or thought something like, "My life stinks because I don't have (a job I love, a relationship, enough money, etc...)" then you are using a narrow lens. It is fine acknowledge the things that you want that you do not have, but it becomes problematic emotionally to define your life by the absence of that thing. It is important to make sure that your panoramic view of your life is accurate- there's no need to make anything up. And if you're having trouble finding positive aspects of your life, I encourage you to continue panning out to a wider view.

~Dr. Stanley

The Myth of "Most People"

"Most people get more accomplished in a day than I do."

"Most people have an easier time getting into a relationship than I do."

"Most people don't struggle with this."

"Most people have no problem eating well and working out consistently."

"Most people have a career path already carved out."

"Most people are more organized and efficient than I am."

These are just a few examples of what the "mythical most people" do (or don't do). Often I hear these complaints from clients who are frustrated with their current status, especially in relation to the "mythical most people" (MMP) who seemingly do things perfectly. What's interesting is that when I press clients to identify a person who fits the bill, they are usually unable to come up with a specific person that they know. Often times the MMP is just that: an ideal, a person who doesn't actually exist. Or a "specialized person": for instance, a movie star or model who's livelihood is based on looking good.

I have found that the MMP can be a self-defeating concept that keeps people stuck. Often times there is a fear of not being able to live up to an idealized standard, which results in lack of movement towards a goal. This is called an approach-avoidance conflict: wanting something, but simultaneously fearing negative outcomes from moving towards the desired thing. Often the feared outcome is a factor so strong as to prevent a person from working towards that goal. This results in a person teeter-tottering or being completely frozen. Another consequence of the MMP ideal is that it can lead to people judging themselves harshly for not living up to the standards of the MMP and not giving themselves credit for their success. This leads to disappointment and, at times, completely abandoning the goal.

You may be thinking, "But I DO know someone who is (organized, fit, in a satisfying career, in a relationship...". Of course you do. There will always be people who are "more" (and less) of whatever is your ideal- there's no denying that. It is important to assess your strengths and limitations, and accept where you are in this moment while acknowledging and working towards where you would like to be- this is called radical acceptance. Without it, you will likely continue to feel stuck in your current situation. Check out this site for more information on radical acceptance.

If you have a goal that you would like to reach and want to use a real person as your motivation, here are some steps to get you started:
1. Identify the person- why did you choose him/her?
2. Ask the person how he/she got to that place that you want to be.*

• What was "easy" (e.g., natural talents or strengths)?
• What were struggles/difficulties/bumps along the way?
• What are current struggles/difficulties/bumps along the way?
• Any advice?

3. Consider your own strengths and weaknesses in light of what the person shared.
4. Practice radical acceptance as you are working towards your goal. Keep in mind that making personal changes involves breaking habits and maintaining the change, which takes time and effort. Change does not occur overnight.

*This step is the best way to dispel the MMP. Many times the MMP is kept alive by assumptions that others have an "easier time" in life. Talking the the motivating person will likely shed light on his/her own struggles early in the process and in the present.

If you are feeling stuck with a goal, take some time to explore whether your stuck point is at the MMP ideal.

~Dr. Stanley

What are you eating?

I love to eat, so a lot of the metaphors I use involve eating.

I think that there is a general consensus that most fast food is not particularly healthy. There also seems to be a general consensus that fast food, on occasion, is ok. The problem, as I see it, is when people eat fast food regularly but trick themselves into believing that what they are eating is healthy. I see people doing this same thing in their personal lives and it is just as problematic.

Here are some elements of fast food:

• It's cheap ($6 meal)
• Pretty easily accessible (drive through, walk up counter)
• Fast (max 5 minute wait?)
• Tasty
• Overall, it provides instant gratification with little time, money, and/or effort

Here are some ways that you may feel after consuming fast food:

• Full! For awhile
• Sluggish
• Depending on what/how much you ate you may have regrets
• Not completely satisfied

Are there any situations or things (including people) in your life that mimic fast food? I'll give you an example that I see often: dating. I wrote a blog post on January 14, 2013 in response to an article written about the "hook up" culture. The hook up culture is a lot like fast food- instant gratification. And if that's what you want, then you've gotten exactly what you wanted. But, if you are wanting a more significant relationship, you are likely to be dissatisfied by the hookup culture. And it's particularly problematic if you trick yourself into thinking that the hookup culture satisfies you. A person who wants a more significant relationship might want something more akin to eating at a restaurant or cooking.

Let's look at eating at a nicer restaurant vs. fast food:

• It's more expensive ($10+ meal)
• If you're driving you have to park your car 
• May require seated service
• You have to wait for the food to be prepared (10+ minutes)
• Tasty

Here are some ways that you may feel after eating at a restaurant:

• Full!
• Satisfied
• A little lighter in the pocket- but wasn't it worth it?!

Finally, let's look at cooking vs. eating out:

• You've got to plan the menu- or you'll make an old favorite
• Expensive initial investment ($50+ on groceries)- but likely cheaper overall per meal
• Takes time to prep and cook (30+ minutes)
• It's fun (generally- again, I like cooking and eating)
• You know exactly what went into your meal
• Tasty!

And here are some ways you may feel after cooking:

• Accomplished!
• Full
• Satisfied- plus there may be leftovers!

Following the dating example, finding a partner who is a good fit takes more time and effort than it might if you were looking for a hookup partner. It requires openness, patience, and creativity. But the idea is that the outcome will be what you want rather than a poor excuse for what you want. Ultimately, the job, relationship, or other life situation that you want will likely take more time and effort to realize. Taking shortcuts may provide instant gratification but likely will not produce long-term satisfaction. 

Think about situations you might want to change in your own life- what will it take to move from fast food living to restaurant or cooking living?

- Dr. Stanley

Are you staying hydrated?

Have you ever been dehydrated? I'm sure that you have. It's a horrible feeling- dry mouth, fatigue, headaches, etc. And, drinking water doesn't provide immediate relief. There's a saying that says something like: "By the time you realize that you're dehydrated it's too late." This is so true.

Our mental health is similar. By the time you realize that you are "mentally dehydrated" it is too late. Here are some of the symptoms of mental dehydration:

• Fatigue, even after getting enough sleep at night
• Mental cloudy-ness, difficulty "pulling it together"
• Irritability
• Sadness
• Physical aches
• An overall feeling of "blah"

Mental dehydration occurs when you do not take proper care of yourself. Basic self care includes eating regularly, drinking water, and sleep- optimal functioning occurs when these are done daily. Additional self care activities include exercise, relaxation, social interactions, vacations and any other activities that "recharge" you- these vary from person to person and are important to do with regularity. 

In my work with clients her in Washington, DC many people believe themselves to be "too busy" to take care of themselves. Some forget to eat meals, stay up too late and get up too early, and neglect working out. And they also forgo time with family or friends for work or other obligations. They end the week mentally dehydrated. I imagine that some of you reading this right now feel mentally dehydrated.

Preventing- or at the least reducing- the incidence of mental dehydration is similar to preventing physical dehydration. I've heard that drinking 8 cups of water daily helps the average person maintain appropriate levels of hydration. Drinking water is not exciting but I do it. I keep water around me at work, and make sure to drink lots of it if I am out at a restaurant or at the gym. It's a mindless activity, but doing so keeps me at a steady level of hydration. Drinking water may feel like a pain- until you are dehydrated and wishing that you had simply had your eight cups of water a day. Mental dehydration similar- you may not think that you have time for basic or additional self care activities, but you'll wish that you had done them when you discover that you are mentally dehydrated.  

Here are some tips for maintaining proper levels of mental hydration:

• Take some time before your work week to look at your schedule for the week. Do you have any big meetings or obligations? Is there anything that you are worried about? If so, make plans for basic care leading up to those activities.
• "I'll sleep when I die" is not an appropriate life motto. Sleep is not overrated- it is your body's chance to rest and rejuvenate. And it allows your brain to organize all that it has taken in during the day. If you have trouble sleeping, give yourself 1.5 hours to wind down in the evening without the TV or social media and without caffeine. Take a shower or bath, read a book, and make a list of what needs to be done and/or any worries. 
• Find a physical activity that you enjoy. I am not the type of person who can go to the gym and walk on a treadmill or use an elliptical machine- I find myself counting down the minutes until it's over! It doesn't matter if I have music or a TV- it's unbearable. I recently joined a gym that has a variety of group exercise classes and I love it. I actually look forward to working out, and I also benefit physically and mentally from the exercise. Find something that works for you.
• Make sure that you are eating food throughout the day. I enjoy eating so I keep this on my radar, but I do have to make sure that I am planning my meals around meeting and appointments. I get crabby and unfocused if I am hungry- I bet you do too, but you may be too busy to notice. Make sure to have snacks nearby in case you are not able to immediately get food when you get hungry.
• Don't forget about your friends/family/romantic partners- they can be a great source of support during a busy work week. And they can provide a nice distraction from work stress.
• There is a point of "diminishing returns" when overworking. Staying an hour later may allow you to be productive, but often your productivity diminishes as time passes by. This likely occurs because you've been at work all day, may not have had lunch, and are now hungry for dinner. If you need to stay late, break it up- go out and grab some food and fresh air, and return to work with a time limit (1.5 to 2 hours). Then go home. You can't do it all- not matter what anyone says.
• Adults need extracurricular activities too- develop a hobby, nurture a talent, join a club or organization. But don't overdo it. If the extracurricular activity results in mental dehydration then you need to cut back and/or find a new activity.
• If you're an extrovert, make sure that you are interacting with other people on a regular basis. If you are an introvert, make sure that you are taking proper care of yourself by spending some time alone and/or engaged in activities that recharge you.

Happy Hydrating :)

- Dr. Stanley

Is Courtship Dead?

This weekend I was sent the article posted in the New York Times on January 11, 2013 entitled The End of Courtship. It was a very interesting article, and in it I read a lot of the complaints I hear from at least one client every day as a therapist. The article explores whether “traditional courtship” is dead and many feel that it is. I say that it is not.

The first part of the article discusses “hookup culture” and many people feeling like they can’t get out of it. Additionally, many believe that it is so widespread that it has taken over and “traditional” dating (e.g., a one-on-one date) is never to return. The fact is that hookup culture does exist, but something that is less discussed is the dissatisfaction that some feel as a result of it. Some people find “hooking up” a short-term solution to a long-term desire—to be partnered. I have spoken to both men and women who desire a relationship with a partner who is mutually interested. The more experience I have working with individuals, the more I have come to believe that partnering with another (at some point in time) is an innate desire that exists in all of us. Hookup culture, I believe, can satisfy some of that desire, but the results are short-term. It’s almost similar to a drug- getting “hits” of the drug feel good in the moment, but continued use is required to maintain the high. Overall, I think that it is important to recognize hookup culture for what it is for some—a short-term fix—and also recognizing that there are other options. Seeking other options takes more time and effort.

A Ms. Freitas shared that many young people feel at a loss when thinking about dating, specifically how to initiate a date and what to say on the date. One pointer that I share with clients about dating is to approach it as they would when getting to know any new person. I believe that dating has become to be viewed as something separate from normal social interactions, something more specialized and intimidating. Dating does require putting oneself “out there” and includes the element of attraction, but the idea is to ascertain the goodness of fit between two individuals. Getting to know a person, rather than getting to know the idealized image of a person, is an important task in dating. If you have any friends then you already know how to get to know another person. I describe dating as similar to a job interview—you may want to impress, but you will also want to make sure the job is a good fit for you. In dating, you meet someone who seems promising, but it may time some time to assess if you like the person and the goodness of fit. The “goodness of fit” factor varies from person to person—so having a sense of what you are looking for helps the process (e.g., similar values, good sense of humor, similar goals, similar interests, etc). And keep in mind this may take some time. I encourage people to have a three date minimum as long as nothing egregious happens on the dates.

The next part of the article discussed the impact of technology on dating. The article states that in the past, picking up the phone to call someone to ask for a date required courage and planning, whereas today’s “dating” behaviors may include texts, Facebook messages, twitter messages, and GChat messages. In my opinion, what’s most important in setting up dates is not how it’s done but the details—who, what, where, when, and how to get there. Detailed plans over any medium are fine in my book. People have preferences for how they’d like to be contacted, and I think that’s fine to share with a potential date, but I don’t think that a date set up over text or chat is less official or respectable etc. than a date set up over the phone. In the article some people lament the lack of effort potential dates put into setting up dates. I tell people that a potential date’s behavior can provide insight into his/her enthusiasm about dating, which can provide valuable information to predict the trajectory of the situation. For instance, if a potential date states “let’s get together soon” and does not follow up with a time, he/she may be casual about dating. So, if you want a serious dating situation you may not (likely will not) find it in the casual date-setter-upper. I’d suggest that you spend more energy with a potential date who either gives you available times/days or who suggests a time/day to meet up.

The final part of the article discusses the fact that “traditional dating” can be expensive, especially in our current economic state. My suggestion is to get creative with dating. As previously mentioned, dating is about getting to know another person to assess “goodness of fit”, so the traditional “dinner and a movie” is not the only way to do that. A “date” can take on any form: coffee; lunch; a snack (e.g., cupcakes—one of my favorites); visiting a museum; taking a walk; etc. The goal is to have opportunities to get to know one another. Believing that a certain amount of money must be spent on a “good” date (I’ve heard that the “magic” number is $200) can be limiting, and may be a false indicator of a person’s commitment to dating. 

Overall I agree that the “hookup culture” is present in our society, but I can say with confidence (from experience and talking to people daily) that people still want to “date” and are dating. Hookup culture can be likened to eating fast food when you are trying to maintain a healthy lifestyle- it’s all around us and is not very expensive, but both the short and long-term results may not be desirable. Just be aware of what you are actually getting. If it matches up with what you want- great. If not, you may want to begin to explore other options.