A patient of mine passed away this week, and it left me with a flurry of thoughts and feelings. When a client dies, after they have spent years and countless hours in therapy sharing their innermost fears, joys, dreams, heartache and love, where does the mourning go?
Therapy is a special kind of relationship. It only works if there is a true meeting of emotions with genuine care. As therapists we spend each hour of therapy weaving through the threads of a persons life, trying to connect the strands to make the full tapestry, and this is inevitably done from a place of compassion, care and even love.
In the world outside therapy there are many different rituals for mourning that are intended to provide comfort for family and friends. They involve shared stories with family and friends but also a space to share the loss and pain. They may make us feel a little more connected to the person who is no longer there as we try to comprehend the permanent intangibleness of ‘death.’ We see other people suffering with the same excruciating grief that we feel and we know we are not alone. Talking about grief does not make it go away, but it does allow us to have a space within which to try to articulate all the thoughts and feelings swirling around in our heads and in our guts. It creates a place to try to make sense of this utterly devastating, breathless pain.
As a therapist you are not privy to this world. Yours instead is a very private, isolating pain that cannot be shared with anyone. It is a form of disenfranchised mourning, as it cannot be acknowledged by society or those around you. The relationship is not a regular, normal one and it is also a private relationship that needs to be honoured and respected with all the ethical boundaries, just as you would have whilst your lost patient was alive. Today I sat quietly in my therapy chair to reminisce, gathering my thoughts and memories of what happened in the therapeutic space. I lit a candle and said a few words, out aloud, and then said goodbye, for now. Next week I will speak to my supervisor or a colleague so that someone can witness and be there with me for a moment, while I sit with the grief and pain of loss.
Dearest D, You were such a vibrant, dramatic, courageous person who worked remarkably hard during our 6 years of therapy. While we untangled the threads of your life, you helped me grow as a therapist and as a person. Thank you for your curious sprit, your ability to create and imagine, you kindness and the generosity of your soul. Thank you for inviting me into your most intimate sanctum. It was a privilege and a blessing to walk the journey with you. You will be remembered and you will be missed. ♡
©Psych in a Box
Addiction, insidious bastard that it is, does not only affect addicts. It can be like a nuclear bomb in a family, flinging destruction in all directions. Loving an addict is very hard work sometimes. Addicts are so much more than their addictions, but it can be hard to see the person you love behind the smokescreen of ridiculous behaviours and addict thinking when they are in active addiction.
The concept of a co-dependent relationship refers to one where two peoples’ lives are so entwined as to be enmeshed. Often it’s based on a rescuer/victim dichotomy, where one parter must constantly prop up the other. Co-dependent people struggle to imagine life without each other and may feel each others’ feelings as if they were their own. If you’re in a relationship with an addict it’s a good idea to check wether your relationship has healthy boundaries in it, or whether you feel that your own sense of self is being eroded.
The temptation to rescue the addict from the consequences of their addiction is strong. However, if you never allow that person to experience negativity, you can’t expect them to stop. Neurologically every cell in their body is telling them that using is helping them; unless there is some powerful information at odds with that, they will never see a need to stop. Sometimes, they need to fall hard before they can bounce back up. But drawing boundaries can be incredibly difficult. Here are some tips to help you with this:
©Psych in a Box
Depression plays havoc with your mind. It distorts your reality and if that isn’t enough it can evoke huge feelings of shame and even self-disgust. The internal self-critic becomes humongous and powerful making you feel less in control and more powerless.
1. Depression’s Bullshit messages:
Your mind somehow screams at you: “You are not meant to be feeling like this!” “You’re alone, you are broken, damaged!” and as you start grieving, it also tells you “you’re worthless, so who would want to be with you?” It tells you “this ain’t gonna change – this is going to be like this FOREVER” and shit, forever is a long time for anyone to endure. But this is just one part of the distortion of depression. There are so many others, like the inability to see that this too shall pass, or the inability to know that these emotions can be met, can be worked with and then will dissipate.
2. The Shame of depression
Depression tells you “you’re weak, hide this part of you, don’t ask for help!” and because this message is ‘out there’ society reinforces it with responses like:
3. There are people with ‘real big problems’
I always remember a saying that I learnt as a little girl and I thought I loved it – until now:
“I cried because I had no shoes until I met a man that had no feet”
The issue with this saying is that it negates what we are going through. It says “stop feeling sorry for yourself – you don’t have real problems.” That attitude encourages anaesthetisation of emotions. Problems aren’t scaled according to size but rather according to intensity. If they feel intense then they are!!! We need to meet that feeling with compassion, find out what it’s about, and grieve the loss; and there is always loss. With time we learn to bear emotions, to sit in the space of pain, to listen to it and meet it so that it can be allowed form an image and then dissipate and not overwhelm us.
4. Suicidal ideation isn’t always about dying.
It’s so hard to speak about suicidal thoughts. They’re the ones that mean “I don’t want to feel this pain anymore, it feels like this will never end; I can’t find my way out of this place, and I wish I could disappear, or that the world would swallow me up. I wish I could – not feel.” We are concerned about telling others because Suicidal thoughts are like leprosy. We feel we are defective humans and others feel we are crazy. We are scared of instilling fear, panic, rejection and even anger in the people we tell. But…. thoughts of suicide don’t always mean we want to die. They can also mean we need to be listened to. We don’t need a quick fix. Of course sleep, exercise, meditation, eating well etc can help…. but if we are in PAIN the pain (just like a broken wing) needs to be attended to with gentle acceptance and kindness.
5. Depression has many forms
Sometimes depression looks calm. Sometimes you glue a smile on your face or paste on a little laugh (for the outside world). At times it could look like someone hidden in the closet in the dark. It can be you working extremely hard, or the playing computer games endlessly in an attempt to feel better. It can come when you are successful or when you have just failed at something. It can emerge when you are just about to embark on an exciting phase of your life, starting university/college, getting married or becoming a parent (in fact grief often raises its head at times of change, because with change comes loss of the familiar) – depression doesn’t discriminate.
Why now? why me? this is unfair…. it’s not helpful to focus on such questions. The focus needs to be what am I feeling? What is this telling me about the mountain I need to climb? Who can support me while I take each little step? How can I support myself better whist I am feeling this pain?
Remember there are two opposing forces that we as human beings have:
The thrust to discharge (where we can get angry, frustrated, upset with those around us and this can make us feel overwhelmed and even make us feel like we’re going mad). In this place we don’t actually feel the pain: we discharge it by railing against the object we have identified as the source of the feeling, and feel the turmoil instead. Our focus of attention here is the frustrating object (our boss, our parents, our partner, our lecturers, our friends).
The thrust to represent (here we are trying to attend to something within us that needs to be embraced and looked after, to be understood, to be met with compassion and to be remodelled into the unity called ‘self’). We need to create an image, a picture of the experience in order to have a conversation with our own mind. Here we can embrace the pain, the sensations, and explore what is happening inside us and start containing it with compassion (and help). The focus is now on our relationship to the object. We have taken that which was outside of the mind, outside of us and taken possession: it is now part of the mind where you have the power to digest experiences while building courage with kindness, trust and believe in yourself.
You can understand these two processes as follows: imagine that someone punches you in the face and walks away. You can rail against your attacker, perhaps hurt them back, focus on what a terrible person they are and so forth (“discharging”). But the pain remains, and it is in YOU, not in the other person. If you can see yourself as being hurt and needing assistance, you can attend to the pain ITSELF. The hurt requires attention and soothing, regardless of how you engage with the other person.
Depression is an individual and a societal problem that should not be dealt with alone. We all need support to find our way when lost. We need to know that it is okay to feel emotions. We need to get rid of should, could, would – I should feel happy, if only this happens then I would be happy…. Its okay to feel sad. Just because somethings is UNCOMFORTABLE doesn’t make it wrong. It is as it is: right now you are feeling pain, and making it WRONG doesn’t make it hurt less. It just is what it is and if we can rather meet ourselves where we find ourselves then we have a greater chance of creating a mind that can cope with the disasters that occur in our lives.
©Psych in a Box
So often we want to create new good habits but beware… this could just be an indirect way of saying “I’m not good enough… I need to change ‘me’ to be valuable.” If this is the motivation for new habits then they will never last. We can’t build someone up by breaking them down, devaluing or even worse, humiliating them. All you will achieve is a greater need to escape the cycle of self-loathing whole or parts of yourself. New Years resolutions are often about transformation and sometimes about achieving the ideal, the unrealistic, the perfect and in many ways a lack of acceptance and rejection of SELF.
NEW HABITS should make us feel More SPECIAL, More WHOLESOME and MORE valued!
A Common feature in this treadmill-life is that we forget about our needs. We are far too busy to give ourselves a break, to smell the roses, to have a cup of coffee without looking at our phone, even too busy to look after our medical needs like going to the dentist or what about that little mole that worries us every now and then. Ok: this needs to change!!! We need habits that are Nourishing and Kind to your soul.
Lets place ourselves on the weekly ‘take care tracker’
The Take-care Tracker can help you to explore and find 10 new habits that would be nourishing for you, to set your intention of how many times a week you think you could do it, to see at a glance what is happening from day to day and to reflect at the end of the week about how much space you were able to make in the week for you. Most importantly it’s way to learn how to place yourself in your life by being mindful and being present!
©Psych in a Box
When I first became a mom I read every article I could find. I looked at tons of information, especially around emotional development, and lots of them made sense, and lots of them were confusing.
One of the confusing ones was about EQ stuff that you want to instil in your child, and it listed things like confidence, and reasons why you want these things for your children. Now it’s obvious that you want confident kids, right? But the bit that confused me was the HOW.
Until it dawned on me: you teach kids by BEING. If I want my daughter to confident, I need to be confident. Oh. And one thing I have struggled with in my own life is body confidence. I really do want my kids to value and respect their own bodies.
Now part of that is how I give them feedback. I can compliment them and focus on how strong and clever their bodies are, how good their bodies are at healing themselves and at learning new things. That’s easy. If I focus on whether they are getting fat/too tall/too freckled, of course I’m going to create a kind of focus that I don’t want, and I want to focus on health. I also believe that everyone has beauty inherent in their own humanity. And we live in a world that is aware of appearance.
But I can’t really teach them to value themselves unless I value me. I can’t remember a time when I thought my mother was OK with how she looked. But the thing about my perception of my mom was this: I didn’t compare her to anyone else. She looked like my mom. When you’re little especially, your special people are your world and there’s beauty in that that has absolutely nothing to do with magazines and expectations. It was important to me that she looked like HER. I want my kids to want to look like THEMSELVES.
So for me to be beautiful to my kids I only need to look like ME. Not skinny. Not perfect. Not unwrinkled. ME. For them to feel good about looking like THEMSELVES I need to give myself permission to look like ME as I do right now.
I cannot remember my mother ever complimenting herself. This is something I’m trying to create for myself and my kids. It’s ok to say “I really like my hair like this”, or “my body feels so good after exercising” or “I love my soft tummy” and mean it. And as a parent, your own choices around health will absolutely create how your kids engage with it. If you’re eating a hundred chocolates a day, they will want to too. You can’t expect kids to make sensible choices around sweets and junk food, so you have to. Which is hard! There’s a balance between permissive and restrictive where things are allowed in moderation, in a way that works for you and your family.
Again, as I’ve said in previous articles, acceptance doesn’t mean never changing: making kind and healthy choices for your body means that you may need to lose some weight or move more, but that doesn’t mean you need to hate yourself along the journey. And it will show your kids that they can accept their own physical journeys too.
©Psych in a Box
It’s a well known cliche that you cannot love others unless you love yourself. I’m not entirely sure about that one, but what I would like to add to that is that it’s incredibly difficult to accept love from others unless you can see yourself as lovable. How you frame your relationship with You is very important. Your relationship with yourself is the one relationship you will have access to every day of your life.
And it’s difficult to be friendly with yourself when you’re feeling bad. You may feel angry with yourself for experiencing pain or being sad. You may be regretful or guilty about decisions you’ve made. And all those feelings are acceptable and can be dealt with, but it’s really important to remember that YOU CANNOT HATE YOURSELF BETTER.
You can’t hate yourself into thinness, or happiness, or social comfort, or intelligence, or a higher salary, any more than you can beat a child into stopping crying. In fact hating yourself can only take an already crappy situation and make it feel ten times worse. In your times of need, you have most need of yourself. If you don’t value and support You, it is very difficult to accept support from others, because you feel so undeserving, and often almost ashamed of your need for support. Also, if you feel undeserving and devalue yourself, the people around you will pick up on that in a thousand unconscious, subtle ways and they will reflect that back to you. In short, if you believe that you are a fool, you will communicate that unknowingly all the time and people will respond to you as if you were a fool.
Acceptance means understanding and being OK with what it means to be human. You ARE human. You cannot deny this: there you sit, right now, in your chair, being human. And thing about being human is that we are imperfect. To accept that you are human is to accept that you are fallible.
Self acceptance does not mean choosing some of your (doubtless many) good attributes or behaviours and being proud of them. You’re completely allowed to be proud of your dancing prowess, or your skill at work, or your ability to bake perfect cookies, but there will inevitably come a day when you don’t dance well, or when you make a mistake at work, or when the baking goes all pear-shaped; and what then? Does that mean you can no longer feel affection for yourself?
Self acceptance also doesn’t mean that you never change or grow. We are by nature designed to grow and to want more: it’s why little babies learn to walk. But reaching for something from a place of gentle acceptance of what IS allows for a much kinder journey.
Oftentimes our inner dialogue reflects the worst of the parenting or guidance we have received: your inner voice reflects the fear and anxieties about imperfections that you may have grown up with, at school or from peers or teachers or often from parents. Sometimes it’s directly related to how we were spoken to as kids, and how we heard our parents speak about themselves. We grow an Inner Bitch, always ready to point out our flaws in graphic detail. It’s as if by giving attention to flaws and mistakes we can magically change them. It’s time to parent yourself differently: soothe, encourage and support the changes you want to make, don’t let yourself off the hook of putting in work that needs to be done, but always accept your humanness. (Parenthetically how you talk to you own kids is important for the same reason, as is how your kids see you treating yourself).
Self acceptance means that you give yourself permission to be YOU, warts and all. If your bum is too fat, embrace the bum-ness of it. If your nose if too big, it’s ok because it looks like YOUR nose. One of my patients once said, “Superwoman is dead. She tried to do everything.” Aspiring toward improvement is one thing; internally killing yourself because you are (unavoidably) imperfect is another. Have you ever hated anyone else because they had a big nose? Probably not. So why hate you?
This isn’t an easy habit to cultivate though. Here are some tricks to help you along the way.
©Psych in a Box