Category: integration

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Another Wave of COVID Grief Five Months In

Door open on mossy path
Door open on mossy path

In the last few weeks, my clients have started grieving COVID anew. Here in Philadelphia, we’re in a modified Green Phase, so we can eat outdoors at tables that stand six feet or more apart. In the city, we can theoretically do small outdoor gatherings of less than 50 people, but honestly, I’m not going anywhere near 50 people. Nor are my clients. We’re still pretty much in shut down mode. We shop for food every couple of weeks and that’s about it. We always wear masks outside the house, except inside our car. My clients report similar phenomena.

For my clients, acknowledging the pain and disappointment of the continuing precautions hurts. Whatever timelines we privately prepared for in March– this progress is slower and more ambiguous. In many ways, the reopening feels more painful and more complex than the closing, because everyone is navigating the new, looser rules with differing priorities, and differing assessments of acceptable risks. Now there is social stigma. We manage the emotional friction between those that continue to wear masks, per CDC guidelines, and those that don’t.

We grieve the understanding that this “Green Phase,” which feels far from normal, is the new “normal.” We’re still not seeing our friends and family with easy hearts. The calculus of who is at risk when we buy groceries endures. We’re still not engaging in the pleasures of travel and outings. Our innocence is stripped away. Seeing crowds on television shows brings out two feelings in me, “Oh my god, you lucky foods, you have no idea what’s coming. Your joy is such privilege” and “Dear lord that’s a superspreader event!” I feel like all my parts have battened down to endure this period of deprivation, of lack of community, of lack of human engagement. So now I ask, and I ask you to ask yourselves: Where is our joy?

Where can I find a sense that life is still a place of excitement and amazement? How do I connect with inner spaciousness? My connection to art and beauty, where has it gone?

It’s so easy to get swept up in my sense of duty and obligation, and to focus on the tasks, to focus on the work, instead of the human needs that have been shunted aside. So here are some considerations, as we hold another wave of grief and loss and the summer winds down:

Now that all plans are provisory, we still need to make plans to add lightness to our weeks. To comfort ourselves. What plans, what joys can we look forward to? My current plan in hatching is going to a drive-in cinema. My other plan in hatching is an evening run to the beach. What will your plan in hatching be?

I’ve switched from video calls (exhausting) to voice calls (intriguing) for keeping up with my friends. This also provides a nostalgia bonus–reminding me of hours wrapped along our long kitchen phone cord as a teenager. Community remains critical to our ability to feel engaged in our own lives and to reduce the isolation that comes with all the sacrifices we make during the COVID 19 pandemic. However you reinforce your sense of belonging, keep it up!

The most important change I’ve made is to check in with myself and consider my needs beyond my obligations. When I wake up in the morning, I ask myself, “What do I want to do for joy?” I then give myself an hour to write, or do whatever it is purely for my joy, my fun, my sense of an expansive self. My work self is critical but secondary.

Since I cannot go on vacation, I can save for vacation, and make a list of places to visit when I get the opportunity once again.

I’m no longer springing for gourmet take-out once a week, but I can enjoy mid-priced restaurants.

I’m eating more local produce and, in doing so, experiencing the seasons. I’m stocking my kitchen with the right tools for my frequent cooking efforts, and this improved kitchen environment lightens the load. My new cleaver can cut through anything, unapologetically.

My scope is shrinking, but in my better moments I like to think I am living more like a poet. Tuned into each moment, slow and aware, and full of gratitude.

I am in the process of completing Level 1 IFS Training and that has helped me reframe my experiences, to look at every moment through multiple eyes, multiple parts, and to realize no one part holds all the wisdom, life’s meaning lies in multiplicity. This means I am never all in despair and never all in hope. I lie in a grounded balance.

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Building Joy

little red boat in a cove

My therapist moved to Florida and the last bit of advice she gave me was to play more and seek out joy. The way I’m thinking about this advice, I should also be a touch less hardworking. One of the quality-of-life measures I instituted in 2019 was to have a slow start each day. I take my time in the morning, have coffee, eat something, take a shower, and only then look at my emails and to-do list. This is one of the ways I try to make time for myself, be more present, and rush less.

I’m anti resolution, but I am in favor of choosing what to bring into my life. So my 2020 wish is for joyfulness and playfulness. I’m still thinking about how to institute this (yes, I want a structured process for my unscheduled joy). I have a few ideas in no particular order. Spontaneity: I want to be more whimsical with my free time. Creativity: I want to write, draw, make, carve, decorate, or put something shiny on at least weekly. Newness: I want to try new things, go outside my comfort zone and enjoy being terrible at new things. Nature: I want to go outside more, ideally among trees, mountains, or near the sea. Art: I want to go see live performances, and exhibits at museums and galleries–I want to be inspired by the work of others. Movement (self explanatory). Community: continue to build my multiple communities. I will also continue doing the things that currently bring me joy: reading fiction, seeing friends, eating new foods.

What do you want to bring into your life in 2020? How can you think of it in terms of calling in joy instead of disapproving of your life of yore?

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Article: Science and the Many Paths to Healing

I love good science. I particularly love science when it gives me language and a good theoretical framework to support understanding of observable phenomena–and offers new paths to understanding. I’m so pleased I live in an age where brain/mind science and nervous system functioning are being so thoughtfully studied. It’s starting to provide some empirical evidence for stuff that, in other decades, might have seemed witchy or intuitive or wacky. Science tends to take a while to catch up to certain kinds of pre-existing wisdom, and then takes the credit for inventing concepts that  were known within wisdoms outside of mainstream medicine/science. One quick example off the top of my head–Cognitive Behavior Therapy is just a fancy name for certain kinds of ancient Greek philosophy and Buddhist mindfulness practices.

All this to say that I’m increasingly trusting the heart, the soul and the body, as well as each person’s creativity, to assist in the mind’s healing process. And also, that while we like to call it psychotherapy and talk about the mind and the unconscious, maybe the mind and the unconscious are fancy constructs (or other types of symbolic language) for heart, soul and body striving together towards unity and self understanding.

Or as my partner would put it, based on a recent Radiolab, if we knew enough about individual biology, we would be able to anticipate 100% of what a person would do (and there is no free will). I see free will working daily in therapy: I think the process of making changes away from your baseline–which is the whole project of psychotherapy–is free will at work. In sciency words: the system trying to re-regulate.

I actually think the biology argument is a silly way of thinking because 1) it’s a tautology–of course everything is a biochemical process at a certain level and yes, the right number of identifiable variables would yield predictive modeling of all human behavior (thank you Asimov for calling that one ahead of time). 2) That’s just one language for describing phenomena. The same way that I prefer to think and speak of traumatized nervous systems that are highly reactive instead of labeling language like a possible diagnosis of “Borderline Personality Disorder.” Both describe similar observable behavioral and physical activation phenomena. However, I much prefer the nervous system science version because it starts to de-stigmatize the experience of those that struggle with their lived experience.

I know I’ve wandered a bit off the map, but I wanted to share what has been on my mind.  Here’s my point, or points.

There’s very strong evidence of a powerful placebo effect for therapies people believe in–regardless of the therapy–with patients being able to assess a reportable decrease in physical symptoms (with more complicated questions about the biochemical basis of these reported experiences of healing. Here’s a fun article about a researcher on placebos at Harvard). This means that for some people a Chakra healer, or a crystal energy healer, or a tribal healer will transform their lives.

This belief in a healing system also helps predict whether psychotherapy will be of assistance to our clients. On a certain level psychotherapists are asking clients, “do you want to believe that I can help you?” The answer should be “yes” and that will help shape what psychologists call “the therapeutic alliance” according to the American Psychological Association‘s Education Directorate (fun name, right?).

If you think Chakra work is going to be integral to your healing process, you better work with a therapist that agrees with you. <<[Also, here’s a book that you would like.] Also, I am a therapist that agrees with you.

I’m writing this in support of those who wish to find healing in other domains, or in addition to the experience of psychotherapy.  Humans are complex, and the healing experiences we will need to move beyond or integrate damaging life experiences will vary as our own understanding of how we function expands or alters. In my case, my belief system was challenged in a wonderful way by deep healing through craniosacral therapy and I wrote about it here. (Here’s an article about the benefits of the therapy while you receive the therapy.)

I’m becoming a nervous system/brain structure nerd.

Other fun texts:

  • Think religion should be in the mix? Here’s a fun article about “spiritual intelligence” helping Iranian teens deal with depression and anxiety.
  • Reiki? (Article from PsychCentral)
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Treating the Whole Person In Psychotherapy

I’ve been really happy with some of the work I’ve been doing with clients lately and the frameworks I’m using in psychotherapy. I’m realizing that I have a really nice toolbox to work with a variety of different aspects of the human experience. As someone who only feels comfortable when I feel I’ve reached a level of mastery, and someone interested in continuous learning and growth, I’m feeling very lucky about having become a psychotherapist at this particular time in the field.

We’re able to do a lot of really interesting connecting the dots between psychotherapy, the human experience and brain (and other) science–for example Siegel’s notion of interpersonal neurobiology (which makes intuitive and professional sense to me)  For example, we already knew that people who have experienced trauma have challenges relating to regulating their nervous systems, and the nervous system’s impacts on their experiences of their brains and bodies. But, more and more, we know why, and we also know ways of providing significant healing experiences at a client’s pace. I’m thinking primarily here of both Brainspotting and Somatic Experiencing, each of which offer approaches that don’t rely on a patient’s ability to communicate using words.

This is a relief for me as a therapist, because I believe that knowledge/feelings/memories are sometimes stored in the brain and body in ways we can’t access with language and conscious thought. We can now do work directly with the nervous system via the body, and with memories via the visual field and the brain/mind. I deeply believe (based on my own life experience, and my experience as a clinician of observing my clients’ bodies during therapy) that as we work to integrate all knowledge about self-regulation and reworking negative experiences, therapists will increasingly treat the whole person. Bringing the unconscious into light and discussing drives, motives and past experiences is necessary and important work, but only part of the puzzle.

I’m really happy to say that I feel increasingly comfortable working with the following different aspects of people’s human experience to help clients. In my case this includes using some of the following approaches/strategies to inform my work:

  • For concrete assistance with improving client behavioral strategies and negative thinking: CBT.
  • For reducing overall distress/anxiety: Deep breathing, relaxation methods like progressive muscle relaxation and mindfulness exercises.
  • For insight: Object relations theory, narrative therapy, relational therapy.
  • For traumatic memories: Brainspotting.
  • For difficult body sensations: Sensorimotor Experiencing.
  • For understanding motivation for changing challenging behaviors/managing ambivalence: Motivational Interviewing.

I’m also a feminist therapist, and I use critical race theory to understand the more damaging aspects of how power works and replicates itself in our society’s functioning. These are also tools for considering the language we use to discuss the “isms” that permeate our lives.

There’s more, but this is a good start. In short, I believe in treating the whole person and helping people develop better coping strategies, experience more positivity in their lives, gain greater peace with their thoughts and bodies, and (of course) gain insights around patterns in their lives and how those patterns were inspired by history and personality.

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Article: Recovering from being too sensitive

Have you ever been told “You’re too sensitive?” or maybe told that your emotional reactions were “too much?”.   According to Dr. Elaine Aron, this experience is fairly common for children and adults–about 20% of the population experiences life as a Highly Sensitive Person.  One of defining features of being “sensitive” is that you might have strong reactions to both sensory and social stimulation. You might need more rest or time to care for yourself. It might take you more time to make sense of your experiences. I find this theory fascinating, because it overlays nicely with the work being done through the Somatic Experiencing Trauma Institute.

There’s already some research confirming that Highly Sensitive People (HSPs) feel emotions more deeply–“that awareness and responsiveness are fundamental features of SPS”–meaning that HSPs will pick up more readily on emotional cues from others, and they will also respond to the emotions they pick up from others more intensely. My professional estimation, based on my clinical experience,  (I’m just starting to look into the research findings),  is that Highly Sensitive People have a more highly responsive nervous system overall. They take criticism and life experiences to heart, and experience emotion within their bodies much more readily than others. But if they can survive the experience of living in their responsive, compassionate minds and bodies, HSPs can do great things in the world. I particularly like this article from Entrepreneur Magazine.

Here’s another preliminary clinical formulation based on my client population, because they are so exquisitely attuned, unfortunately, HSPs often have challenging childhoods, and difficult teen years, which can impact their overall functioning by the time they are adults. The good news is that the world of psychology is increasingly finding great new strategies for helping those who are highly sensitive calm their nervous systems, through mindfulness strategies, and by incorporating knowledge gained through the polyvagal theory, for example.

So if you feel that your sensitivity has made life more challenging for you than for others, you’re on to something. And if you’re ready to get some support and find a more comfortable way of being in the world, please know that strategies do exist (I’m very interested both in Somatic Experiencing and in Brainspotting) and that I’m ready to do that work with you.

(One of the most exciting aspects of being a therapist is when different concepts come together and suddenly the puzzle pieces fall into place in a meaningful way and you find powerful new language–I’m so excited by this line of inquiry.)

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Article: Creating Meaning & Healing Personal Rituals

Is there something you want to celebrate, mourn, think about communally, or notice in your life, but aren’t sure how to go about it? (Lots of meaningful life events go unacknowledged by us and our communities because they don’t fall within the valued and acknowledged cultural rites of passage.) This could be a change in relationship or career status,  the diagnosis of a health condition, the loss of a friend or family member, or coming to terms with new understanding about your life’s course. If your usual strategies don’t feel quite sufficient, develop a personal ritual (regardless of your religious or atheist upbringing). Here’s how.

The dictionary definitions of ritual all include two parts and I’m going to add a third:

  1. Acts that have meaning
  2. Carried out in prescribed order
  3. With the right people present (my addition)

Steps to create a ritual?

Acts

This is the biggest piece of the equation. It imbues common activities with intention and power. What do you like to do? Which activities have meaning for you? Let’s say you wanted to mourn someone’s death, or the loss of a relationship. You could engage in acts of remembrance: recognize the many gifts of the relationship, what wisdom was passed down, what now lives in you because of your contact with this person. You could do this remembering by journaling, sharing pictures, playing a song, reading a meaningful poem or passage from a book, telling jokes, or sharing correspondence. You could summon friends and ask them to bring an object from a lost relationship. You could tell them to only bring snacks, or French food, or ice cream, because that is the food you associate with that relationship. Are you letting go or bringing something into your life? You could burn a candle, light some incense, mark an object.

Order

It’s important to have an opening and an ending in each ritual. Do you want the experience to be more active (say, involving dancing), or quieting–encouraging reflection, and maybe solitude? Do you want to move through different forms of celebration and remembrance? What three activities (or more) would be fun to do with the people with whom you will share this ritual?

The Right People

Do you want to do this alone, with a couple friends, or with a larger group? Which people in your life have the capacity to be playful, creative, thoughtful, quiet, or funny in the ways you’ll need to carry out your ritual?  Think carefully about who would understand your need to engage in this activity. Consider what kind of support you’ll need and who is best suited to be that support through the ritual. Pick a day and time and invite those people over.

Bringing It All Together

I’m going to share two quick examples of rituals I have previously created and used.

When I was in college, I would mark the end of each semester (meaning the day I finished all my final exams) by taking the dried flowers that I had collected in my bedroom over the course of the semester and throwing them into a rushing river nearby. I would then go to the movies to know I was in celebratory mode (once I got to see Rocky and it felt particularly fitting), and then meet friends for one exhausted drink at a bar.

When I lost my French grandmother a couple of years ago, I was unable to travel back to France for her funeral. So I created a ritual of remembrance and invited friends over. I picked out music that made me think of her. I served some French food. I shared a poem read by Billy Collins that I thought she might appreciate. I showed pictures of her and her home, and my recent visits. I asked everyone present to bring an item that reminded them of their grandparents, and to be prepared to share a story about their grandparents. About 15 people came, and we told stories, and it was a very moving afternoon.  Making time for this community ritual helped create some closure–I knew I had honored my grandmother’s memory, had marked the moment and created a new memory.

Why? I wrote this article because I often have conversations with clients where something important has happened to them, but it doesn’t fall within the bounds of activities that are typically commemorated through ritual. This doesn’t mean that a meaningful ritual can’t be created, and I encourage them to do so.

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Article: Checking In with Yourself for Self-Care

Wisteria at Longwood Gardens

Another way to care for yourself is to make time to check-in with yourself at the beginning of the day, and at the end of the work day, when you still have a little time left to engage in self-care.

Before you start asking yourself questions, take a moment to take a few deep breaths and center yourself.  Bring yourself back to the present instead of rushing ahead in your mind. Making time to acknowledge what you need, on many different levels, can  help you prioritize how you use your time that day. The hope is that when you arrive at the end of the day, you feel a greater sense of satisfaction and purpose.

  • What does my heart need today? What’s my interior emotional tone? Am I calm, nervous, worried, a little worn down, or sad? Once you acknowledge your emotional tone, ask yourself: What would be the best thing I could do to support my heart today?
    • Should I make some time to be quiet by myself?
    • Would reading a good book help?
    • Should I reach out to someone I love who loves me back?

Pick something you can do for yourself and schedule it into your day.

  • What does my body need today?
    • Am I tired?

If you’re tired, make sleep a priority for three nights this week. Schedule your bedtime.

    • When was the last time I had some vegetables or ate some fruit?

If this question is hard to answer, make a point of adding something from the garden to your diet today.

    • When was the last time I exerted myself or went for a nice long walk?
      • Ask yourself, can I add a little more walking to my day? If so, when can I do it?
      • Did I make a date with myself to go to the gym, or take an exercise class?
      • Can I ask a friend to join me in a physical activity?

Protect your time, mark it in your calendar.

  • What does my spirit need today? Should I make time to meditate, to laugh, read an inspiring text, journal or pray? How can I connect with the divine or spiritual in my life today? If not today, then when this week?

If this is a personal priority. Treat it accordingly. Make time for it.

  • What does my mind need today? Is there a question or activity or task that my brain wants to take on? Am I craving excitement, information, accomplishment, or something else? Once you acknowledge your mind’s needs, decide whether you can make time to act on this desire.

I’m placing the mind lower on the list of priorities, because I believe that our U.S. culture prioritizes the mind, and puts the body, heart and spirit last–which is why I’ve inverted the order in this particular article.

At first, acknowledging these different aspects of yourself and making time for them might feel strange, or even selfish. But the more you nourish all the different pieces of your self, the more you will be able to give back to the people who share your life.

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Thinking about Self-Care

One of the things I’m interested in exploring in this space is how we can use our skill sets to acknowledge our needs, and then tend to our selves, so we can be grounded, and focused, and integrated as we move through our personal and professional lives. The self-care movement has had some interesting critiques in its recent revival, (see The New Yorker, and The Atlantic articles), but I don’t think this negates the need for a daily check in with the self–and a tending to our internal self. There are many conduits to connecting with the self, so my goal isn’t to be prescriptive, but to help each person assess their resources, and knowledge and then use their strengths and networks to improve their wellbeing and focus.