6 Steps to Trusting Yourself

6 Steps to Trusting Yourself

“The suffering itself is not so bad; it’s the resentment against suffering that is the real pain.”
-Allen Ginsberg

 

When I first started my own work with mindfulness and radical acceptance, I found myself saying, “I’ll accept this feeling/ this symptom so that I don’t have to have it anymore.” That’s… not really acceptance but it was the best I could do at the time. Since working with clients around mindfulness and radical acceptance, I have heard this sentiment hundreds of times. It’s hard to get behind the idea that accepting our pain or feelings or aversive experiences has therapeutic value, that it could ever help us to make positive changes. Acceptance and Commitment Therapy is driven by just this, accepting the hard-to-accept.

 

Acceptance and Commitment Therapy was created by Steven Hayes in the early 1980s and tested by Robert Zettle in the mid-1980s. It is a form of Cognitive Behavioral Therapy (CBT) and is based on Skinner’s Radical Behaviorism. Acceptance and Commitment Therapy’s (ACT) main objective is to help participants turn toward their feelings and symptoms instead of resisting them. The protocol helps participants learn how not to overreact nor underreact nor altogether avoid the associations with these feelings and symptoms. With ACT, we learn to accept ourselves and the experience we are having in the present moment so that we can commit to a behavior aligned with our values.

 

ACT succinctly describes the change in psychological flexibility in this way:

 

We go from F.E.A.R.

 

F- fusion with our thoughts

E- evaluation of our experience

A- avoidance of our experience

R- reason-giving for our behavior

 

To A.C.T.

 

A-accept our reactions and be present

C- choose a valued direction

T- take action

 

In the book, Acceptance and Commitment Therapy: The Process and Practice of Mindful Change by Hayes, Strosahi, and Wilson, we’re given the six core principles to help us develop psychological flexibility:

  1. Cognitive de-fusion: Learning methods to reduce the tendency to reifythoughts, images, emotions, and memories.
  2. Acceptance: Allowing thoughts to come and go without struggling with them.
  3. Contact with the present moment: Awareness of the here and now, experienced with openness, interest, and receptiveness.
  4. Observing the self: Accessing a transcendent sense of self, a continuity of consciousness which is unchanging.
  5. Values: Discovering what is most important to oneself.
  6. Committed action: Setting goals according to values and carrying them out responsibly.

 

ACT emphasizes mindfulness because presence of mind/contact with the present is the only way to change behavior. Now is the only time that we can truly choose a behavior. We miss important external and internal cues to help us determine what is happening in the present moment by thinking about the past or the future. Awareness of the present moment helps us to differentiate between what we are afraid is happening and what is actually happening. It helps us to describe what is happening and then make choices in response. Jon Kabat-Zinn describes mindfulness as “paying attention in a particular way, on purpose, in the present moment, and nonjudgmentally.”

 

The “acceptance” part of ACT is problematic for some. “So then, if I’m supposed to accept my feelings and my experience, does that mean I’m supposed to accept abuse and maltreatment?” The answer to that will always be no. When we accept our feelings and experience, it means we accept the information that we are receiving and can make choices based on that information. It means that we accept that this is how it is right, not that this is how it should continue to be.

 

When we practice acceptance of what’s happening we can mindfully make choices that are in alignment with our values. I like to use this phrasing in my own life and when working with clients: “I’m going to keep choosing the same behavior of ______ because I care about______.” Or “I’m going to change my behavior to ______ because I care about ________.” So, someone might say “I am going to keep choosing the same behavior of confronting people when they treat me with disrespect because I care about my feelings and how I’m treated.” Or “I’m going to change my behavior to respectfully disengaging from an argument when it no longer feels productive because I care about my feelings and this relationship and I know that continuing in unproductive conversation usually leads to hurt feelings and resentment.”

 

Sometimes the choice is hard to make. For instance, “I choose to go to bed earlier so that I can wake up feeling more refreshed” is a great behavior goal. But what if it means sacrificing quality time spent with loved ones? This is where present moment focus and acceptance of your experience comes in handy. You might prefer to spend the time with your loved ones and wake up feeling a little more sluggish.

 

I know it’s hard to identify choices so let’s do it together. If you want to talk more about Acceptance and Commitment Therapy, changing behaviors, or anything else, please call or email me.

 

Love and Be Loved,
Natalie

What Is Gender

What Is Gender

Gender is confusing. It’s often used and understood as a synonym for sexual genitalia. Consult any dictionary, and you’ll see. And while, in our culture, both terms are inextricably linked with one another, they are different. They’re associations with one another (and our staunch adherence to them) have proven oppressive and dangerously limiting.

For some, it’s never an issue; they’re born, they are raised as the sex they were assigned at birth, identify with that sex and its associated gender, and it’s all good. For many others, it’s not so easy. Some of us feel confined by the limits of our current conceptualization of gender upon which our society has agreed and enforced for generations.

Even in places where people self-describe as open-minded and accepting, a cis man wearing a dress is assumed to be in costume, and a femme or high femme woman with fully grown out leg hair is a spectacle.

Gender is a construct, and we have agreed that being masculine means one thing and being feminine means another. Many of us who disagree with this construct do so while following the rules. We feel that we are following these rules against our wills. When people do break free and live authentically, however outside the norm, they are mocked, isolated, bullied, attacked, and even killed.

For years, in the Trans community, “passing” has been a goal. Some want to pass in hopes of feeling in alignment with who they know themselves to be. Some want to pass to look and feel like and be accepted as a “real” man or woman. (Please note that I am absolutely simplifying this concept.) This is a testament to the generations of patriarchy, toxic masculinity, sexism, and misogyny that inform our culture. Men must “look like men, ” and women must “look like women.” To this day it’s still an issue of safety as MTF (male-to-female) people are the most targeted members of our community. (And MTF People of Color make up a substantial portion of that group.)

Obviously, this is not true for every Trans person. There are plenty of people in the Trans community for whom passing isn’t much of a goal, and there are many who’ve found more peace and happiness after transitioning. Happiness is a universal goal, and many eventually find it after they have transitioned. (Most people don’t find immediate fulfillment; transitioning is often a long and arduous process during which a person can face various types of rejection and self-doubt. Years of managing the stress brought on by denying oneself, living in fear of being rejected for living authentically compounded by the stress of letting go and allowing oneself to transition is an enormous undertaking.)

But there is a whole group of people who identify as Trans and don’t want HRT (Hormone Replacement Therapy) or surgeries. Some Trans people want HRT but not surgery. Some want some of the surgeries but not all and don’t want HRT. Some FTMs will never look the way we’ve been conditioned to identify as male, and some MTFs will never look the way we’ve been conditioned to identify as female. Most of us assume that when someone transitions they’ll start behaving and presenting in a way that our culture affirms as masculine enough or feminine enough.

We have decided what is masculine and feminine, which characteristics are ok to swap and which are definitely not ok. Straight men can have long hair, but they can’t wear makeup. Women can have buzz cuts and abstain from shaving body hair, but they’d better be Lesbian. Our culture puts an incredible amount of pressure on its members to conform to its rules and has assembled a loyal and persuasive army of militant enforcers who are always more than willing to defend these rules.

In response, so much dangerous adherence to these limits is the notion of being gender-fluid. Gender fluidity is gaining momentum. A lot of people don’t feel they should have to comply with a certain presentation based on their genitals. So they don’t. They identify and present however feels most authentic to them. They don’t ask for permission. They don’t appease. People who are gender-fluid have looked at the gender, and sexual constructs created by the dominant groups in our culture and have opted out. They are creating a safer, more inclusive culture where we are not defined by our presentations or ruled by binaries and either-or options.

I’m often asked about “detransitioning” and how common it is. This is a complicated subject and will take time and commitment to discuss. If you have any questions about what I’ve written or would like to discuss detransitioning, please contact me. I’d be more than happy to talk about this with you.

 

Love and Be Loved,
Natalie

Can My Relationship Be Saved?

Can My Relationship Be Saved?

Most of us want security in our relationships. We’re wired to be social so, when we feel like our social standing is threatened or that our intimate connections are unreliable, our brains process it as actual danger, and we freak out.

Some of us crave security and validation of our places and safety in our relationships but can’t seem to find partners with whom we get that. We tend to find and are attracted to people who provide us with incredible highs (and incredible lows), drama and a push-pull style of interacting. When we’re in relationships with partners who help us to feel more secure and receive validation of being loved, respected and cared for, we often feel bored. We mistake the tension-relief cycle and the excitement of the highs and lows for love. This type of behavior is common in those of us who have an anxious attachment style. We think we want security (and we do but getting it also stresses us out) and then when we get it we’re not interested.

 

Look at this scenario. Let’s say you are in the middle of a pretty unstable intimate relationship with a partner. To friends and family, the relationship is fraught with various dramas and issues; everyone thinks it’s run its course and just needs to end. You acknowledge that there are problems, but think you can work through them. You might even believe that you can’t live without your partner or that there is no one you could ever love as much. Your partner is ambivalent about your future as a couple which is weird because when you first started dating, they came on strong and made you feel like you were the only person in the world. Now, you’re lucky if you get a text back. Much of the relationship consists of a good couple of months and then a breakup or the threat of a breakup. Even when things are good, there is a lot of discord because you don’t feel prioritized by your partner and they experience you as suffocating. When it’s good, it’s really good, but when it’s bad, you feel like you might lose your mind. When you’re at work or out with friends, you are often distracted and thinking of your partner, waiting for their text or call. If they do contact you, all of your attention is fixed on them. You often threaten to end the relationship, but when an actual breakup happens, it’s either initiated by your partner or because they are the one who follows through on your threat. You think the relationship would be perfect if you partner would make only a few changes to your dynamic. After all, you’ve sacrificed a lot of your expectations and some of your values in a desperate effort to make this relationship work. You often say you’ve never loved anyone so much until now. This is also one of the most unstable relationships you’ve ever had.

 

In this example, you are exhibiting anxious attachment behavior. It doesn’t necessarily mean that you have an anxious attachment style. During the course of our lives, we are in relationships with people who might connect us to various styles of attachment. If this relationship is representative of most of your intimate relationships, then it might be more likely that you have an anxious attachment style.

 

People with an anxious attachment style (or who have enough of a propensity for it) feel themselves pulled to people who have an avoidant attachment style. The partner above is a pretty good example of someone who might have an avoidant style of attachment or at the very least displays some features. This is usually pretty rough going because while one partner craves validation and is insecure about space in the relationship, the other partner is looking for more space and is insecure about giving validation.

 

This is a pretty crazy-making, taxing cycle. To add insult to injury, the more we engage in this cycle, the more insecure we become. I know it probably feels like there’s no winning here, that you can either be with someone you love but who can’t give you the security you need or be with someone who can give you that security but not a satisfying connection. I would love to talk with you more about this. Please contact me if you would like support.

 

I recommend reading the book Attached., by Amir Levine and Rachel Heller. It’s a great resource for people struggling through these and similar patterns.

 

Love and Be Loved,
Natalie

How Do I Know If I Need Therapy?

How Do I Know If I Need Therapy?

“So about how long should it take until I feel better?” “How long do you think I’ll need therapy?” “How many sessions should I expect to attend before my problem is solved?” I have asked all of these questions during time spent on the other side of the couch. I know what it’s like to want concrete answers and expectations met. Everyone wants a sure thing in the face of so much uncertainty.

Therapy is not exactly a sure thing. Surely, it can and does help, but it’s not as simple as basic input of time and results yielded. Results depend on client honesty (with themselves and the therapist), right fit with a therapist, client’s commitment to the work both in and out of the therapy office, and right fit with whatever therapeutic modality is used.

Therapy is almost never a quick fix, but there are quicker-fix type/brief therapeutic modalities available. Whether or not these protocols are right for someone depends on a lot- personality, history, diagnosis, whether or not a person has experienced complex trauma. Even in the best of scenarios, it still requires the practice of skills through time to maintain results.

Under the psychotherapy umbrella, there are five really (really) broad categories we use to organize treatment strategies:

Psychoanalysis and Psychodynamic Therapy:

Makes the unconscious conscious, insight oriented. Emphasis on client-therapist relationship. Brief therapy model (20 session maximum) is not the rule, but is available for single-incident trauma like an attack, rape, catastrophic event, targeting a single life shift.

Examples of Psychodynamic Therapy: Jungian, Dream Work, Attachment-based

Often used for: Increasing self-compassion, improving self-concept, self-actualization, mood disorders, relational problems, trauma, developing insight to identify and manage internal conflict, shifting external locus of control to internal locus of control, couples, families,

*Psychoanalysis: Multiple times per week. The therapist is a blank slate onto which client projects their beliefs and experiences. Relies heavily on free association.

 

Behavior Therapy:

Focuses on conditioning new behavior. Uses brief therapy model.

Examples: Applied Behavioral Analysis, Aversion Therapy, System Desensitization

Often used for: Phobias, Addiction, Anger issues, Impulse control problems, self-injury

 

Cognitive Therapy:

Focuses on changing thought pattern. Uses brief therapy model.

Examples: Rational Emotive Behavioral Therapy, Cognitive Behavioral Therapy

Often used for: Phobias, Addiction, Schizophrenia, Bipolar Disorder, Suicidal ideation, Anxiety disorders

 

Humanistic Therapy:

Focuses on cultivating personal accountability and reaching highest potential. Emphasis on free will. Uses both brief and long-term therapy models.  

Examples: Gestalt, Client-Centered, Transpersonal, Solution-Focused, Adlerian  

Often used for: Improving self-concept, self-actualization, improving communication with others, cultivating self-awareness, shifting external locus of control to internal locus of control, couples, families, existential crises  

 

Integrative or Holistic Therapy:

Often referred to as “Eclectic Therapy.” (Some practitioners will basically fight to the death in disagreement over whether or not Integrative is also Eclectic.) Uses various modalities depending on what is indicated for each client. One therapeutic modality combines various features of the previous four categories. Uses both brief and long-term therapy models.  

Examples: EMDR, Narrative, Cognitive Behavioral, Dialectical Behavior, Internal Family Systems, Gottman Method, Transactional Analysis

Often used for: All of the above

 

Some people prefer to see the same therapist for various issues they’d like to target while others seek out a different specialist to treat each issue. There’s no right way to do this, just whatever feels like it’s working for the client. Some clients come with an agenda and leave when their goals have been reached. Some stay for a while after because they like having a professional to talk to who’s all about them. Plenty of people try therapy and find it difficult to give themselves over to the process, take a more passive route to treatment, get frustrated and give up. Sometimes this is because traditional psychotherapy is not a good fit for them right now, maybe ever. There are so many other great therapeutic options. Traditional psychotherapy is not the only way to heal or feel better.

 

I know it’s overwhelming to look for a therapist and decide which kind of therapy would be best for you, especially when you’ve been dealing with a problem for years, and you’ve finally decided to take the plunge and ask for help.

 

If you describe the issue and a little bit about yourself, many of us will be able to direct you in the right direction. There are plenty of therapists who won’t do this because they are sure that they can handle it regardless of their training and orientation. While I would like to believe that this is mostly the exception rather than the rule, it happens. If you feel too overwhelmed or busy or exhausted to educate yourself on various therapeutic tools and modalities, remember that you can interview multiple therapists at a time to see who feels like the best fit for you. (You can also do this regardless of your stamina to self-educate.) Once you start seeing a therapist, you can audition us. If you’re not feelin’ it for some reason, you can switch. It’s ok not to like your therapist or to like them, but feel like they’re not actually helping you. Therapy is an investment, and you have the right to switch providers at any time for any reason. If you’re feeling like you need to discontinue treatment, I usually recommend addressing this with the therapist; sometimes it just takes a little direct communication to shift things. Even if you don’t plan on continuing your work with the therapist, honest feedback is good for both sides.

 

If you’d like to talk more about this, please email me or call and I would be happy to answer any questions. This is one of my favorite subjects!

 

Love and Be Loved,
Natalie