Take a Vacation! (It's Good for Your Health)

By Heather Matzkowitz, LMSW

Many of us place a great deal of importance on our jobs. We work long hours, try to never miss a day unless we are sick, and put a lot of time and energy into our careers. This is all important, don’t get me wrong, but it's just as important to take time away from work. There are a multitude of physical and mental health benefits to gain from taking a vacation.

The average employee in the United States takes only half of their assigned vacation time. People often have the misconception that in order to be successful they need to sacrifice their happiness. However, research has shown that by taking time off from work you’re going to be more productive, have higher performance, and improve your relationships with others. Vacations help to reduce stress by distancing us from the environments and daily activities that we associate with stress and anxiety. It's important to note that taking several smaller vacations per year has been shown to be more beneficial for increasing overall wellbeing as opposed to taking one long vacation. 

So what exactly are some of the benefits of taking a vacation?

Mental Health: Vacations make us feel good and happy, especially while planning them (aka the ‘pre-vacation high'). Rumination, which is the anxiety-creating tendency that enables us to focus on things in our lives that cause us distress, has been shown to decrease during vacations and remain low several weeks after being home. Returning to work after time off helps you to feel less stressed and more focused. 

Physical Improvements: Sleep quality is improved and mood continues to remain heightened during and after returning home from a vacation. Studies have also shown that taking vacations can decrease the chances of getting heart disease.

Career: Taking a vacation reduces burnout rates, which enables you to be to be a happier and more diligent worker. Travel has also been shown to boost creative thinking, which can improve work performance. 

Relationship Improvement: A vacation can help promote emotional bonding and bring you and your partner closer together. Spending time together in a different place can help you rediscover the foundations of what made you a couple in the first place. 

Going on a vacation that is far away can be expensive, so picking a vacation that is close by home is likely to be more affordable and just as beneficial for the soul. Go away for a weekend (or week) to a small cabin in the woods, or enjoy the warm weather by relaxing on a beach. While vacationing you should try to minimize doing work related tasks (yes, this includes sending emails) and going on social media, especially if you are away with your partner. Doing this will increase partner bonding and allow you to truly immerse yourself into relaxation. So what are you waiting for? Go take some time and plan your next vacation! 

Heather Matzkowitz, LMSW is a therapist at Cobb Psychotherapy. If you would like to work on work/life balance, visit cobbpsychotherapy.com to learn more about how therapy can help.

Podcast Review: Hurry Slowly

By Sarah Spitz, LMSW

A friend recently recommended the podcast called Hurry Slowly, which is all about "how you can be more productive, creative, and resilient through the simple act of slowing down."  The idea of "slowing down" is scary for many New Yorkers — we live in a world in which being busy gives us social capital, and we are constantly bombarded with messages that we aren't doing enough, we aren't successful enough, we don't have enough, that we aren't enough.  And faced with this, it can seem impossible to slow down. 

But what is lost if we live our lives in this way? Unfortunately, quite a lot.  We lose out on productivity, creativity, and we sacrifice our mental health.  I appreciate this podcast because it sheds light on exactly what we're up against, and the host Jocelyn K. Glei is committed to providing knowledge, resources, and insight into how we can live and work with more meaning.  

While there are many great episodes to choose from, I wanted to briefly highlight a minisode I listened to recently called, "The Tyranny of Choice." The episode is dedicated to exploring the anxiety many of us experience related to choice, and Glei interviews Renata Salecl, author of the book The Tyranny of Choice, which is all about decision-making.

We have been conditioned to believe that there is an ideal outcome for every choice we make, and as a result we invest immense time and energy into make the "right choice." This depletes our creativity and it takes away from our happiness. Not only does that resonate with me personally, but it comes up all the time in sessions with my clients. I frequently see anxiety, frustration, and paralysis when it comes to decisions. So how do we find freedom from this?  While this short episode can't answer this fully, it does give us a place to start. We must practice making the choice to embrace a little more chance in our lives.  Who knows, you may find more space for creativity, growth, and happiness! (And stay tuned for my next blog on practices to help cultivate this freedom). 

There are already 30 episodes of Hurry Slowly available, and if the minisode I described didn't resonate with you, there may be another episode that does.  Glei interviews people from all different industries (entrepreneurs to philosophers to marathon swimmers), who provide insight and perspectives that are helpful regardless of what you do professionally.  I definitely recommend this podcast for anyone who is curious about finding a better work/life balance, or is in need of a reminder that it's okay to slow down.  

Sarah Spitz is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Springing Into Summer With Self-Care

By Kristen Quinones, LMSW

The transition from spring to summer brings more than just warmer temperatures. For some it means graduation, moving, starting a new job, or having more social and family commitments. Although these things can be exciting, they also are an adjustment. Transitions can be difficult and warrant more self-care. It can be helpful to plan ahead to implement a different self-care plan as summer approaches. Three things to consider are practicing self compassion, prioritizing stress management techniques and your health, and effective boundary setting and communication skills.

Self-Compassion
Sometimes we can be a little hard on ourselves during transitions. We may tell ourselves we should be able to function the same way now than we did before the change. However, change brings more stress onto our minds and bodies. If we can speak more kindly to ourselves, practice patience, and recognize that we need more self-care now to compensate for the added stress, the transition can go more smoothly.

Prioritizing Stress Management and Health
Regardless of change, taking care of your physical and mental health are important. Often during times of high stress we can put our health appointments or relaxation techniques on the back burner, feeling that we are too busy to take care of those things. However, this is the most appropriate time to put your health first. A transition is when you should definitely make that therapy appointment, meditate, or go for that half hour walk! We function at our best when we have maintained our health.

Boundary Setting and Communication
The social calendar fills up in the blink of an eye in the summer. It is okay to decline some invitations if you know you are scheduling too much of your time. Take an honest look at a typical week of what you would like your time to look like and decide how many social commitments are a good balance for you. If you know you need one day or afternoon every week for yourself to decompress, add it to your calendar and make it a priority. When boundary setting with friends, communicate your needs and that you value the relationship, and try to make time to show them you care in other ways. If boundary setting is challenging for you, consider exploring it with your therapist.

Kristen Quinones is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Using Pain as a Tool for Healing

By Dan Perlman, LMSW

Many clients report a nearly debilitating emotional pain from their past or current relationships, which impacts their ability to think and can paralyze their decision making.  This brought to mind something I read in Principles: Life & Work a book by hedge fund manager Ray Dalio: “When you fall and you get banged up, reflect, there's a lesson there." While this may sound more like a social scientist than a calculating billionaire financier, it’s a powerful point I find applicable in session. When clients come in feeling their path forward is blocked anxiety or depression, I try to support them in breaking them free.  We work to harness the power of their pain and use it as fuel to move them forward. Just as Dialo says, we’ve got to “reflect” upon our pain to make “progress,” and that’s literally what we do. 

Thomas Edison said he didn’t fail, he just found 10,000 ways not to make a lightbulb. The 409 cleaner under our sinks was named for the 408 failures before the cleaning solution was perfected.  Pain isn’t always a bad thing —it is a message that something is wrong and we need to acknowledge it and find another way. Many people spend lifetimes avoiding the pain or backing out of therapy once confronted with the pain. Self-reflective clients take pain and turn it on it’s head to create learning opportunities. I believe the positivity we bring clients in session provides a holding vessel for their recovery. 

Putting it into formulaic terms,  Dalio says, “Pain + reflection=progress,” and that is helpful both on the trading desk and in the therapy room. 

References: 

Dan Perlman is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Koru Mindfulness - Mindfulness for Millennials

By Kaylen Hagadorn, LCSW

Often when we hear or think about the common practice of mindfulness, what we're thinking about is based on the Mindfulness-Based Stress Reduction (MBSR) model created in the 1990s. Traditional mindfulness courses encourage people to meet twice a week for 8 weeks, and ask their students to practice meditation for 30 minutes twice a day. While this is an effective model, it's not feasible for many busy young people between the ages of 18-29. 

Researchers at Duke University observed how busy college students were, so they attempted to find a way to introduce mindfulness in a quicker and easier way. Koru Mindfulness evolved from this and was developed by psychiatrists Holly Rogers, MD & Margaret Maytan, MD for the college students they worked with at the university's counseling center. The program consists of one 75 minute class per week, for 4 weeks with a daily meditation commitment of 10 minutes. The program is taught in small groups and is tailored to address skepticism of mindfulness, build motivation, and includes content that is relevant to young adults. Research showed that this method produced reductions in stress and sleep problems, as well as an increase in mindfulness and self-compassion. 

The program is becoming widely taught at colleges around the country, as well as community centers, wellness centers, and yoga studios. To learn more about Koru and whether it might be beneficial to you, check out The Center for Koru Mindfulness' website at: http://korumindfulness.org.  And if you're interested in teacher certification check out their upcoming trainings: http://korumindfulness.org/teacher-certification/workshop-listings/

Sources: 

Kaylen Hagadorn is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Emotional Deprivation & Schema Therapy, Part II

By Rosie Barton, LMSW

In my previous blog post I wrote about the concept of emotional deprivation and schema therapy. I discussed how someone might feel lonely, disconnected, or dissatisfied, though they have a hard time identifying an underlying reason for feeling this way. In this post, I’m going to be writing more about the three different types of emotional deprivation and how you can begin to shift this schema and engage in healthier coping mechanisms. You can read my previous blog post here to see if schema therapy and emotional deprivation might be something that resonates with you.

Emotional Deprivation is often so hard to detect because you might not even know that you were deprived! There are three different realms in which you might not have had your needs met in an adequate way during childhood, which could contribute to these feelings of emptiness. You could have been deprived of nurturance, empathy, protection, or maybe a combination of all three. 

  1. How much warmth and physical affection did you receive when you were growing up? How were you comforted or soothed when you were upset? If you can’t recall frequent physical connection with your caregivers, you might have experienced a deprivation of nurturance.
     
  2. Empathy on the other hand, is related to whether or not you felt understood by your caregivers. Did you feel that you could trust them with your feelings? Were you validated when you were upset? 
     
  3. And finally, a deprivation of protection occurs if you didn’t feel safe as a child. Did you have someone you could go to when you needed support? Did you have the sense that someone was looking out for you and that you could rely on them to be there consistently? 

A deficiency in any one of these three areas as a child can lead to the feeling that something is missing from your adult relationships. It takes consistent effort, but it is possible to overcome emotional deprivation. I will outline three steps that can help you to change this schema, though I recommend seeking the support of a therapist to process these memories and emotions. You don’t have to do this work alone.

The first step is to begin to understand your childhood deprivation and to access your emotions about what you experienced. You might realize that you feel angry or sad, and it’s important to feel the full breadth of your pain in order to begin healing. It can be helpful to use imagery during this stage. You can create images in your mind from specific memories in which your needs for connection weren’t met. During the imagery exercise, aim to fully experience the emotions that come up for you. Try to connect to that young place within you and to feel compassion for the child who needed something that he or she didn’t receive. 

The second step is related to the present and your adult self. It’s crucial to monitor your current feelings of deprivation within your relationships. Can you get in touch with your needs for nurturance, empathy, and guidance? Are you able to identify when you feel more connected to those things and when your feelings of emptiness are activated? Perhaps when your partner or friend is unavailable, you notice that you begin to feel empty or rejected. Again, it’s important not to block out any of the emotions that might arise. 

By becoming aware of the origins and the present nature of your emotional deprivation, you can start to clarify the patterns that you get stuck in repeatedly. It’s helpful to look into your past relationships during this stage. Are you constantly finding yourself in relationships where you partner is unable to meet your needs? Are you driving away those closest to you with constant demands? Or are you bored with people who treat you well? Emotional Deprivation can manifest itself in many ways, which is why it’s so useful to work with a therapist who can provide insight and perspective. Through your work together, you can identify what the unifying feature of your pattern is so that you can create a list of the pitfalls to avoid in future relationships. 

Emotional deprivation will not dissipate immediately, but through this process, you can slowly chip away at it. Each time it gets activated, you can counter it with your thoughts, feelings, and behavior. This will mean entering into some unfamiliar (and often times scary or uncomfortable) territory, but ultimately this work can help you experience your life as much richer, rewarding, and more fulfilling. 

Rosie Barton is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Eating Right for Mental Health 

By Heather Matzkowitz, LMSW

I was listening to a podcast the other day titled 'Eating Right to Feel Good,’ which I found to be very insightful. A growing body of evidence suggests that people who suffer from depression may benefit from changes in their diet. If your body lacks essential nutrients, then it may not have what it needs to produce important brain chemicals (i.e. neurotransmitters). Serotonin is a well known neurotransmitter that regulates happiness, anxiety, and overall mood. Neurotransmitters are nourished from the nutrients that we consume. 

Research has shown that the modern western diet, which is high in saturated fats and refined processed foods, can increase depression likelihood by 50 percent. Alcohol, which is a depressant, should be consumed in smaller quantities as it can also contribute to depression. In the podcast, Dr. Leslie Korn talks about the importance of interpreting the messages we get from our cravings and then substituting healthier options. For instance, if you are experiencing a craving for chocolate, your body might be needing the mineral magnesium. Chocolate is rich in magnesium, which has a relaxing effect on our mood. We may crave chocolate without knowing that part of our body wisdom is saying, ‘give me more magnesium.’ The issue is that most chocolate is high in sugar, a pro-inflammatory food. Dr. Korn discusses how we now understand depression as an inflammatory disease, not a lack of serotonin. When reaching for chocolate try to go for some dark chocolate instead. 

To boost your mood, try adding more of these foods: 

  • Low-Glycemic foods (i.e. most fruits and vegetables, beans, minimally processed grains, low-fat dairy foods, lentils, nuts)
  • Magnesium (found in dark chocolate, avocados, bananas, nuts, legumes, tofu, seeds, whole grains, leafy greens, fish)
  • Omega-3 Fatty acids (walnuts, flaxseeds, chia seeds, sardines, salmon, mackerel)
  • Tryptophan (oats, chocolate, milk, yogurt, red meats, cottage cheese, fish, poultry, chickpeas, almonds, pumpkin seeds, spirulina, peanuts)

If you want to make changes in what you eat, try starting with small changes. For example, if you’re eating roasted peanuts, try switching to raw peanuts. If you’re eating milk chocolate, try to switch to dark chocolate. It’s important to check in with yourself and ask, “What foods make me feel good?” And “What foods sap my energy and make me feel depressed?” Make it a practice to be mindful of these answers when making food choices throughout the day. 

Heather Matzkowitz is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Understanding Attachment Styles

By Dorette Greene, LMSW

In a previous post where I discussed Emotionally Focused Therapy, I indicated that I would later discuss attachment theory and attachment styles. My goal is to provide some information to help you understand attachment and how it affects your relationships with others, particularly romantic relationships.

Attachment theory was first conceptualized by psychologist, psychiatrist, and psychoanalyst John Bowlby to explain parent–infant relationships and connection.  However, in recent years, attachment theory has been applied to adult romantic relationships as well, serving to provide context to how these relationships develop and function.

The parent-infant relationship can be viewed as the earliest and likely most important intimate relationship. It is this initial connection that gives rise to either attachment security or insecurity (more on this later). It is within these particular interactions that individuals begin to form their most general ideas not only about those around them, but about who they are in this world. While the purpose of attachment is to form attachment bonds that help maintain closeness and proximity to loved ones, the most salient goal is the reduction of negative feelings and emotions as it relates to feeling connected to loved ones.

Although attachment bonds originate in infancy, they continue throughout the lifespan often influencing and changing an individual’s internal working model of “the self,” which is a person’s view of him or herself and others. An individual having a positive working model of the self is often associated with beliefs that they are worthy of love and belonging, and it also serves to reinforce the idea that others are reliable and responsive to their needs.

Attachment type relates to these beliefs and are usually contextualized into two dimensions— secure and insecure attachment. This can be broken down further into three distinct attachment styles which include secure, anxious and avoidant attachment.  Correlations can be made between an individual’s attachment style and their functioning and behavior in romantic relationships. For instance, insecure attachment such as anxiety and avoidance are correlated with maladaptive and unproductive relational behaviors (cheating, risky sexual behaviors, relational violence, etc.).

Secure attachment is born out of the general belief that those with secure attachment styles usually have a positive overall view of themselves and others. This allows them to maintain a positive view of themselves that isn’t hindered by negative interactions with others or negative patterns of interactions in their relationships. Secure attachment is often learned through the caretaker-child relationship and continues into peer/friend group interactions and then into adulthood and romantic relationships.

Insecure attachment on the other hand can present as anxious as well as avoidant attachment. Anxious attachment generally resembles worry, fears, and doubts regarding relationship security. Examples may be negative, and at times even irrational, thoughts regarding being rejected and abandoned, and even uncertainty regarding self-worth and worthiness of love and belonging. 

Avoidant attachment is characterized by the extent to which an individual recoils from closeness and intimate connection, dislikes depending on others, and downplays the importance of relationships altogether.  Avoidantly attached individuals often are unable to get their emotional needs met as they often minimize their need for emotional relatedness.

Attachment styles and the way they manifest in our behaviors and thoughts, particularly as it relates to relationships, can be as pervasive as the way core beliefs manifest in how we interact with the world. Even though we first learn our attachment style very early in life, attachment styles are not fixed, and as such, an individual’s attachment style is capable of change over time.

References:
Hepper, E. G., & Carnelley, K. B. (2012). Attachment and romantic relationships: The role of models of self and other. In M. Paludi (Ed.),The psychology of love (Vol. 1, pp. 133 154).Santa Barbara, CA: Praeger

Dorette Greene is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Challenging Our Distorted Thinking Patterns

As humans, it is common for us to develop certain thinking patterns. Many of these patterns reflect self-doubt, defeat, uncertainty, and negative self-perceptions. There are a number of questions we can practice asking ourselves in order to challenge our deeply rooted and distorted thinking patterns. Northern Ohio University Colleges of Medicine and Pharmacy present a helpful resource, based on Aaron Beck’s Cognitive Behavioral Therapy. Here are a few questions from their resource you can practice on a daily basis to expand your thinking, build perspective, and challenge your thoughts:

  1. Am I confusing a thought with a fact? 
  2. Would my thought stand up in court, or be dismissed as circumstantial? 
  3. What objective evidence do I have to back it up and to contradict it? 
  4. Am I jumping to conclusions? 
  5. How do I know what someone else is thinking? 
  6. Am I assuming my view of things is the only one possible? 
  7. Is the way I am thinking now, helping me achieve my goal? 
  8. Or is it standing in the way of what I want? 
  9. What are the advantages and disadvantages of thinking this way? 
  10. Am I asking questions that have no answers? 
    • How can I undo the past? 
    • Why aren’t I different?
    • What is the meaning of life? 
    • Why does this always happen to me? 
    • Why is life so unfair?
  11. Am I using ultimatum words in my thinking? 
    • Such as always/never
    • Everyone/none
    • Everything/nothing
  12. Am I concentrating on my weakness and forgetting my strengths? 
  13. How have I coped with similar difficulties in the past? 
  14. Am I blaming myself for something which is not really my fault? 
  15. Am I taking something personally which has little or nothing to do with me? 
  16. Am I expecting myself to be perfect? 
  17. Am I using a double standard? 
  18. How would I react to someone else in my situation? 
  19. Am I assuming I can do nothing to change my situation? 
  20. Am I predicting the future instead of experimenting with it? 

References: https://www.mcgill.ca/counselling/files/counselling/20_questions_to_challenge_negative_thoughts_0.pda

Cherise White is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

A Podcast Review: “Where Should We Begin?”

By Alisha Bennett, LMSW

A client of mine recently reminded me of the name Esther Perel — a name that I started hearing last year and continue to hear among friends of mine, client’s, and colleagues. If you are in a relationship, regardless of whether it is extremely healthy, or has it’s many challenges, I highly recommend her podcast, "Where Should We Begin?"

To give a brief summary, Esther Perel has been a couple’s therapist for over 30 years, and is also an author and now podcast extraordinaire living in New York City. Her podcast has now completed two seasons and she is currently working on her third. Esther’s podcast consists of approximately 40-45 minutes of her work with real client's that is part recording of sessions and part her providing explanations about the couple or reason for a treatment decision. 

Here are some insights from her podcast to consider if you are looking for some new perspective in your own relationship: 

  • No matter how different the couple on each episode is from you and your partner/significant other, you can always learn something about how to better your relationship. 
  • We often see perfect relationships portrayed in movies, on television, and on social media. Listening to this podcast shows you that all couples are flawed and have to work on bettering their relationships and bettering themselves. 
  • Initially, I thought that it would feel intrusive and odd to start to listen to real couples in their counseling sessions. I thought, "this is going to be so far from real-life, in the same way that the Real Housewives is." However, “Where Should We Begin?” is the exact opposite. Although many of the couples' issues were far from my real life, I could relate to every couple in some way. 
  • Even when the couple appears to be very dissimilar to you and your spouse, the principles and advice Esther gives may resonate with you and there are likely many parallels that can be drawn to your own relationship. 
  • This podcast reminds me that we all have backgrounds that have led us to where we are now and who we are in our current lives. Every relationship faces problems and conflicts and always will. To be in a relationship with no conflict or issues is not reality. “Where Should We Begin?” normalizes this and helps you to better understand ways to deal with these issues together as a couple. 

If podcasts are part of your commute or daily routine, or if you’ve been thinking about starting to integrate them into your life, Esther Perel’s is highly recommended by many (Particularly if you are in a relationship or are seeking to make improvements in future relationships). 

If you are interested in learning more about Esther Perel or her podcast, visit: https://www.estherperel.com/podcast

Alisha Bennett is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

What Does Self-Care Look Like For You?

By Salina Grilli, LMSW

Self-care has taken off in the wellness community with articles, bloggers, and even influencers asserting the myriad of benefits that come from simply slowing down and taking time to connect with oneself. 

But what does self-care actually mean? When I talk about the importance of self-care with my clients, I often find it difficult to describe what exactly self-care means. Isn’t it self-explanatory? If you were to look at the definition of self-care, it essentially boils down to making a conscious effort to take care of your basic needs. 

What I have found, however, is that self-care means something different for every person. For example, think about a Mom with three young children. Self-care for her might simply mean taking a shower every night and fueling her body with nutritious foods that give her energy.  For a 20-something work-a-holic, self-care might mean taking a quick 10-minute break during the day to de-stress.

Point being, what your bestie swears cured her anxiety, might not be helpful for you. Establishing a self-care routine and finding what works for you will take time and practice. Here are some ideas to begin integrating self-care into your life:

  • Take a long, warm shower before bed.
    • If you are feeling adventurous, try incorporating essential oil or a scented body-wash into your routine.  Focus on finding a scent that you find soothing and relaxing. Lavender, rose, jasmine, and chamomile can be especially calming.   
  • Light a candle when you get home from work.
  • Mindfully take a few minutes to take some deep breaths (Check out our therapist Amy Brightman's blog post on how deep, calming breaths can be used to reduce stress and anxiety).
  • Sneak out on your lunch break and go for a short (or even long) walk. 
    • Maybe venture down a new block and see if you can notice something you’ve never seen. The city is full of wonderful surprises. 
  • Get a monthly (or even weekly) massage.
  • Keep a gratitude journal
    • Write down three things that you are grateful for every night before going to bed. This can range from your parents being in good health or being thankful for your favorite barista.
 (Photo taken from  Chelsea   Baker ) 

(Photo taken from Chelsea Baker

Salina Grilli is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Let’s Get Back to Basics with Sleep

By Shaudi Adel, LMSW

Over the past few weeks I've noticed that the topic of sleep has come up in sessions pretty frequently. Usually, it’s brought up in regards to sleep quantity and quality problems. This makes sense, given that we are in the long stretch of time between President’s Day and Memorial Day when work doesn’t throw us an observed holiday, and when midterms strike for students and all-nighters seem like the only viable option to stay afloat.

Repeated sleepless nights have an impact on emotions, negative thought patterns, impulsive behaviors, and physical health and well-being. Sometimes, I think we overlook the significance of adequate and restful sleep because of how simplistic it may seem – in fact, when I do a brief assessment on sleep, many people say that they’ve completely forgotten how sleep deprivation can affect them physically and mentally! Let’s get back to basics and answer some questions to determine if we can make some changes to move sleep up on our priority list:

  1. How many hours of sleep on average do I need to feel rested or wake up feeling energized? Over the past week, how many nights did I meet this target?
     
  2.  Am I getting to bed around the same time every night, including on weekends? If not, how can I make changes to get to bed at a relatively regular time? Similarly, am I getting out of bed around the same time every morning, including on weekends? If not, how can I make some changes to ensure I am staying as consistent as possible?
     
  3. What is my nightly routine in preparation for sleep? Can it be enhanced with anything, such as a guided meditation, to relax the mind and body before bedtime?
     
  4. What is my screen time on my phone, laptop, and/or TV like before bed? Am I ending my screen time at least 30 minutes before bed?
     
  5.  Am I drinking caffeinated beverages (coffee, black tea, soda) after 5pm?
     
  6.  When I can’t fall asleep, what do I do? What are my thoughts like? Can I get up and engage in an activity, like read a book or write my to-do list for tomorrow?

If sleep has been on the back burner, hopefully these questions can help guide you to make some improvements to your routine around sleep. As Marsha Linehan describes it, “when it comes to sleep, ritual is everything.”  Today, find a way to honor your mind and body and engage in some serious self-care with sleep.

Shaudi Adel is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

How to Relieve Event Planning Stress

By Erica Cramer, LMSW

Spring is a great time of year. As the weather gets warmer (let’s keep our fingers crossed) people become more motivated to be socially active and are inclined to plan fun gatherings. Whether it is an extravagant wedding or a small dinner party, planning an event can often be exciting and challenging. Although it is important to consider other people’s wants and needs, it is crucial maintain your sanity during the planning process and create a product that makes you proud. The following tips will help ensure that this is the case:

1. Stay focused.

When you start planning your event, create a concrete plan and stick to it. Set realistic expectations for the final outcome of the event and ensure that you have the resources and time necessary to properly execute it. When you see yourself losing focus or making unnecessary additions, refer to your initial plan to see how those additions align with it.

2. Create boundaries around planning and do not let the event consume your life.

With modern day technology, the planning process can be a 24/7 activity. It is important to devote a specific amount of time each day to planning and not let it be something that takes over your entire life. It is very easy for planning to transform from productive to obsessive. If you find yourself in bed every night browsing Pinterest or Instagram, it may be a good time to re-evaluate your boundaries and ensure that you make time to unplug from planning.

3. Ask for help when you need it.

There is nothing wrong with asking others for help (especially when it is something that they can do well, enjoy doing, or can do easily). This is a good way to take all of the stress off your plate and make planning a more fun and collaborative process. 

4. Remember why you decided to have the event in the first place.

When people become overwhelmed and stressed out they have the tendency to question why they decided to have the event in the first place. When you feel this way, take a deep breath and a step back. Write down all of the reasons you are having this event and what exactly you want to accomplish. Whenever you feel this way again, look at your list and it will be helpful in allowing you to regain focus.

5. Don't second guess yourself.

It is vital to have the confidence to execute your decisions and not question decisions that have already been made. You are the expert of yourself and the event you are planning, therefore you know best. Think of your decisions carefully before you make them and once they are made look forward not backwards.

Erica Cramer is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Finding the Right Fit

By Amy Brightman, LCSW

Beginning your search for a therapist can be daunting, especially if it’s your first time in therapy. You’ve gotten to the point of realizing it would be helpful to see someone, but the uncertainty of who to see and what the appointment will be like can add another layer of hesitation. Here are a few tips on searching for the right therapist for you:

If at first you don’t succeed, try, try again
Finding a therapist is like dating. You might meet the right therapist for you on the first try, but if not, don’t worry, you might have to “shop” around. Every therapist is not the same. There are different approaches, techniques, specialties, and even personalities that can impact your experience. The main priority is to find a therapist who can help you with the areas you'd like to address in therapy. Getting into the how and why is part of finding the right fit.

Share the sharing
Yes, during your first session you will do a lot of the talking so the therapist can begin to understand what brought you in, who you are, what your life has been like, and what you’re life is currently like. With this said, it’s important for you to know about your therapist as well. It’s totally fine to ask your therapist about their work and educational experiences, what their style is like, and how they approach therapy. Are they directive or passive in sessions? Do they work within a specific framework, such as cognitive behavioral therapy? Do they work with specific issues? If a therapist does not share this, feel free to ask. You both are equally trying to understand if this is a good match.

Assess Your Needs
Before your first session, you may be asked to fill out an intake form that will ask questions to get a better understanding of what brings you to therapy and what symptoms you experience. These forms can be particularly helpful for practices so they can match you with a therapist who specializes or is experienced with specific symptoms. If you are not asked to complete initial paperwork, consider these questions for yourself. What do you identify as your presenting problem? For example, if it is anxiety, what does your anxiety look like, feel like, and how does it impact your daily life? It can also be helpful to think about what you respond well to and what you are looking for. For instance, do you respond well to structure and goal setting or do you need more of a supportive, exploratory approach? This isn’t to say that a therapist has one or the other, but rather it’s to think about what you want and need from therapy so that when you find it, you’ll know it.

Make A Commitment
Therapy is a commitment, and if you are unable to make a commitment to your therapy, it will be difficult to see results and benefits. Typically, you can expect to see your therapist once a week. This will help you hold yourself accountable, use skills, and stay active with your goals. Therapy has become more and more accessible recently, particularly with the increase in telehealth platforms that allow therapists to hold sessions even when you’re traveling for work. Therapy is not only a commitment of time, but also of money. If you don’t have in-network benefits, work with your insurance company to find out what out-of-network benefits you have or if a sliding scale can be offered. Some therapists or practices will help you figure out your benefits. At Cobb Psychotherapy, we have experienced staff who will work with you and your insurance company to figure out your benefits.

Discuss Expectations
You will have expectations of your therapist and your therapist will have expectations of you. Discuss what these are so you both are on the same page. Expectations can range from: How do you get in contact with your therapist if you need to? Will there be homework? What are your goals for therapy? Knowing some of these answers will ensure that you and your therapist are working together and approaching therapy as a team effort.

Remember, when sharing your thoughts and feelings with a stranger, it’s completely understandable to feel strange and uncomfortable, but over time your nerves will decrease if you have found a good client-therapist match. Finding that balance of feeling supported and challenged can be a good indication of this. It's worth taking time to find your match so you can feel confident and hopeful about getting optimal results from therapy.

Amy Brightman is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

3 Tips for Finding Lasting Love [Online]

By Allie Lewin, LMSW

The search for love can be exhausting. At times, finding a partner can even seem impossible, especially when the norm for meeting someone special these days involves swiping a screen populated by selfies. While some folks meet their significant others in college, through work, or through friends, many singles spend over an hour per day on dating sites or apps eager to find love. 

So how can we make this tiresome process more efficient and successful? How can we stop wasting our time on the person who will never turn into more than just a drunken hookup or a situation consumed by two months of back and forth texting followed by radio silence? Maybe the process of online dating can never be a quick means to finding love, but research on dating in the 21st century shows certain attitudes and behaviors can help people successfully find love online. Here are three tips to increase your chances of finding lasting love online.

1. Don’t Judge Pictures Too Much

It’s very easy to shutdown a perspective suitor based solely a picture. Physical chemistry is an important component of any romantic relationship, so it’s completely understandable that when faced with the decision to show interest in a perspective partner online we put a fair amount of emphasis on looks. However, studies show that in general people are more selective online than they would be if they met the person IRL (in real life). When comparing user activity data from OkCupid and a blind date app to investigate the extent pictures affect response rates, OkCupid creators found that on OkCupid, women who received higher ratings in attractiveness were less likely to respond to men with lower ratings; however, when the same couples were matched for a blind date through the second app, these women reported having a good time. Christian Rudder, a co-founder of OkCupid, explained “people appear to be heavily preselecting online for something that, once they sit down in person, doesn’t seem important to them.” 

This is all to say that in the pursuit of love, a few good or not so good pictures on a profile are even less meaningful than we believe. By swiping left or not responding to a message because the person “doesn’t look that cute” or “isn’t your type,” you are immediately eliminating a potential match you may have been stoked about had you met at a bar or at a coffee shop. Makes you think twice about your next swipe, right?   

2. Meet Up Soon After Matching

I’ve joked around with friends and clients about the importance of meeting up with a prospective partner soon after matching in efforts to keep the momentum going, but it turns out there is an actual “tipping point” in online dating when too much communication before meeting up affects the chances of the relationship working out. When there is too much communication prior to meeting face to face we tend to idealize the person and naturally feel let down when the person doesn’t meet our expectations. According to a 2014 study, the “tipping point” occurs after 17-23 days, so waiting any longer than that to actually meet becomes risky. In general, the more effort we spend getting to know someone before actually meeting them in person, the more disappointed we are likely to feel if the relationship doesn’t go anywhere (which makes the dating process even more exhausting!). If you’ve matched with someone and think there could be potential, I suggest trying to meet up within a week or two to give yourself the best chance of being pleasantly surprised by your potential mate and to decrease the likelihood of burn out. 

 3. If You Are Unsure, Go On At Least Three Dates  

In our attempts to find the perfect person in a sea of endless options, we all too often shut down potential partners before getting a chance to see who they really are. This haste often leads to missed opportunities for connection. The importance of continued interactions in dating is supported by what social psychologists call the “mere exposure effect”: repeated exposure to a stimulus tends to enhance one’s feelings toward it. In the context of dating, the mere exposure effect implies that the more we hang out with a potential partner, the more likely we are to develop strong feeling towards that person. Not only do you become more familiar with the person the more you see them, but you also start to get a picture of how that person relates to others and views the world, providing a better a sense of whether compatibility truly exists. So if you go on a first date and come away from it feeling unsure, don’t feel discouraged. Love at first sight may exist, but most love takes time. Give the person a chance, let the mere exposure effect kick in, and allow yourself the opportunity to sort out where your feelings really lie before saying yay or nay.

Not putting too much emphasis on pictures, meeting up soon after matching, and giving yourself adequate time to get to know someone in person can hopefully be helpful in making the online dating process a little less exhausting and more fruitful. That being said, I think it’s important to acknowledge part of what makes relationships special and ultimately work are the experiences we learn from along the way. So while the search for your partner may not be graceful or easy, as an individual you are ultimately benefitting from the opportunities dating provides for learning about yourself and what you are really looking for in a companion. 

References: 

  • Ansari, Aziz, and Eric Klinenberg. “How to Make Online Dating Work.” The New York Times, The New York Times, 13 June 2015, www.nytimes.com/2015/06/14/opinion/sunday/how-to-make-online-dating-work.html.
  • Fox, Margalit. “Robert Zajonc, Who Looked at Mind's Ties to Actions, Is Dead at 85.” The New York Times, The New York Times, 6 Dec. 2008, www.nytimes.com/2008/12/07/education/07zajonc.html.
  • Ramirez, Artemio, et al. “When Online Dating Partners Meet Offline: The Effect of Modality Switching on Relational Communication Between Online Daters.” Journal of Computer‐Mediated Communication, Wiley/Blackwell (10.1111), 17 Sept. 2014, onlinelibrary.wiley.com/doi/full/10.1111/jcc4.12101.

Allie Lewin is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

 

Recognizing Stress Awareness Month This April

By Vanessa Kensing, LMSW

Did you know that April is Stress Awareness Month? I recently discovered this when I was trying to decide what to blog about this month, and found that it really spoke to me.  Stress Awareness Month (emphasis is mine), is a month where we can dedicate ourselves to becoming more aware of stress. But what does that mean in practice?  The definition of awareness includes both knowledge and perception, and in the context of stress, are equally important! Therefore to build awareness around stress we first need to understand what stress is and how it manifests.

Stress is the response to a threat, either real or imagined. In small amounts it can be motivating and not cause harm, but in sustained and intense amounts it can impact one’s emotional, behavioral, interpersonal, and physical well being. Building awareness around how stress manifests for you can help in finding tools to effectively cope. Below are a list of ways that stress shows up in our life and what you can do to cope:

Being easily agitated, frustrated or moody

  • Monitor your thoughts to see where cognitive distortions may be impacting your emotion
  • Build self-soothing techniques to aid in emotional regulation

Feeling overwhelmed and out of control

  • Identify what you can control and make efforts to address more manageable tasks
  • Speaking with others to help gain perspective and get feedback

Having difficulty relaxing

  • Meditation, visualization
  • Breathing exercises

Aches and pains in muscles, clenched jaw

  • Yoga
  • Progressive relaxation exercise

Only seeing the negative

  • Utilize a thought defusion technique
  • Speak with others to help gain perspective

If you are anything like me,  you have allowed stress to be your constant companion without much thought. And in doing so, you haven’t left yourself much room to imagine a life where you are in control of your stress, instead of your stress controlling you. Therefore, when it comes to perception, how we perceive our stress can be integral in how we cope. Seeing it as something manageable, purposeful, and in our control can aid in utilizing necessary coping strategies mentioned above.   

Working with a therapist can help you learn, explore, and engage in techniques mentioned above to help manage stress. If you are interested in working with someone please reach out to Cobb Psychotherapy!


References: 

Vanessa Kensing is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

The Narcissist and Echo Dyad in Borderline and Narcissistic Personality Traits and Disorders

By Nadine Burgos, LMSW

The tales of Greek and Roman mythology that have been passed down throughout the centuries still serve as powerful lessons for us today. In Greek mythology, Echo, a forest nymph, falls in love with the egocentric youth Narcissus.  When he shows clear signs of rejecting her, she struggles through an attachment system which anxiously seeks him, despite his unrequited love. She engages in the masochistic task of echoing back to him all that he says. For her, echoing is painful and humiliating in this context since Narcissus sadistically exploits and rejects hers. All of Echo’s attempts to try to resolve her anxious attachment through an emotionally unavailable character are met with contempt.  The story of Narcissus is an allegorical representation and central feature of codependent behaviors in dysfunctional relationships.  A codependent giver or highly empathic person may mirror, echo, and compliment another at the expense of their own self-worth and dignity. In the case of egocentric Narcissus, falling in love with his own image was a punishment rendering him incapable of empathic love of another. 

Personality Disorders are a complex and controversial topic. It’s important to guard against loosely throwing out terms and labels without the understanding that personality is complex, fluid, and changes throughout developmental life stages. However, personality disorders are stable and debilitating and are often difficult to even identify. Writing about narcissism and borderline personality disorder is in an attempt to educate and encourage examination on the impact they weigh in on our lives.  It is not uncommon to come across an individual with a personality disorder as nearly one in ten individuals in the U.S. qualify for the diagnosis. This statistic is higher for those individuals on the sub-clinical trajectory.  

We all in some way or another have encountered individuals who have displayed narcissistic traits. Some have been introduced to us through literature, film, and the media. We are inundated by political smear campaigns, spewed by questionable leaders who shroud behind accusations of bullying, adultery, collusion, and treason. In 2017, the movement of #MeToo set the platform for publicly exposing the pervasiveness of sexual harassment and assault. Culturally, we question the fabric of a society that sacrifices our natural environment and resources in exchange for profit and power.

The book, The Culture of Narcissism: American Life in an Age of Diminishing Expectations, by historian Christopher Lasch, examines the roots and ramifications of the normalization of pathological narcissism in the 20th century. Lasch reasons that post-war America has produced a personality-type consistent with clinical definitions of "pathological narcissism.”  On a macro level, narcissism invades entire social macro-systems. As industries and corporations shirk social values and collectivism, the culture of narcissism continues to rise.                                                  

Narcissism falls on a continuum from healthy to pathological.  Narcissistic Personality Disorder (NPD) comes in many varieties with many variables and co-morbidities. Neurotypical individuals may exhibit narcissistic traits yet may not qualify for a clinical diagnosis under the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). A healthy sense of narcissism allows us to develop healthy self-love and confidence.  Healthy self-love allows for us to appreciate and respect that we have made real achievements in our lives.  We also develop the ability to overcome challenges and setbacks. We overcome these obstacles by engaging in mutually empathic relationships with other people.

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Narcissism become problematic when an individual’s narcissistic traits move across the continuum and beyond the social construct of what is considered socially, psychologically, and morally acceptable.  There are now many differing levels and categories of narcissism. At extreme levels and with further impairment, narcissism can result in a personality disorder (PD) diagnosis. On the narcissism spectrum, you will find sub-clinical narcissism teetering away from the center with a proclivity to lean towards the left or right.

The essential features of a personality disorder are impairments in personality, self and interpersonal functioning, and the presence of pathological personality traits. The Cluster B Personality Disorders (antisocial personality disorder, borderline personality disorder, histrionic personality disorder, and narcissistic personality disorder) are marked by a codependent, neurotic need to feed off of the reactions of other people. Cluster B Personality Disorders are stable, maladaptive personality disturbances and can also be considered a cultural condition. Individuals with personality disorders can be described as being highly emotional, dramatic in nature, or erratic. Clinicians and mental health professionals use criteria from the DSM-5 to diagnose individuals.

So are personality disorders born or made?  There are two schools of thought about the origin of personality disorders.  Etiology is complex and remains unclear despite various theories that have been proposed. These include cultural, evolutionary, Gene X environment, and parenting and developmental models (Cambell and Miller, 2011).  Some suggest that there is an Amygdala dysfunction which directly affects emotional regulation and limbic resonance. Without this structural component of our brains, there is no capacity for empathy. Nurture argues that a traumatic childhood, neglect/abuse, or even overindulgent parenting can lead to one becoming narcissistic. 

The role of parenting styles in the development of young adult narcissism was investigated in a longitudinal study from Block and Block (1980). They examined  parenting and inherited genetic factors in subclinical grandiose narcism. The results showed that parenting styles had a direct effect on the development of healthy narcissism, but the effect on the development of maladaptive narcissism depended on the child’s initial proclivity towards narcissism. The study found overpraised children showed narcissistic traits six months to a year later.  BPD is approximately five times more common among people with close biological relatives with BPD.

 

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One of the distinguishing traits of Narcissism from other personality disorders/traits is the individual’s inability to truly feel and exchange feelings of empathy. Rather than having “feelings,” they merely register disconnected “intensities” which gives the impression of someone on the Narcissism spectrum as being emotionally stunted. Perhaps one of the most challenging aspects of narcissism is that individuals struggle to understand how their behavior impacts others. Unless they are mandated to attend treatment, most won’t be lined up to embark on a journey of introspection and self discovery with a therapist, especially if they don’t recognize that there is a problem within themselves.  Pat MacDonald, author of the paper "Narcissism in the Modern World," shares, “Traditionally, it is very difficult to reverse narcissistic personality disorder. It would take a long time and a lot of work.” Clearly, some may be in denial about their issues, and more still are fully aware of them and even embrace them. Narcissists are not always easily detected and often appear shy, coy, very polite, professional, and courteous. They gain the victims trust by mirroring and projecting the traits of those they wish to emulate.

The narcissist may bring traits of co-dependency into the relationship through demands, defenses, projections, and boundary infractions.  Individuals who are highly empathic and/or have borderline tendencies/traits are more likely to engage in relationships with individuals with narcissistic traits and/or NPD disorder. One of the distinguishing traits of Borderline Personality Disorder from other personality disorders/traits is the individual’s anxious/neurotic preoccupation with alleviating their anxious attachment style by seeking empathic emotional validation.  Individuals with BPD can feel empathy, however they may struggle with issues of co-dependency as a result of seeking to fill their emotional void through another person.

One symptom common to those with BPD is chronic feelings of emptiness. To counter these feelings, he or she may use sex as a means of trying to fill a vast void. These individuals may protect themselves from rejection/abandonment by acting so agreeable to others, via their mirroring capacity or through engaging in sex as a way to reinforce connectedness. For the narcissist, sexual partners may be characterized as trophies used to enhance his or her self-esteem and self-worth.  Rather than building an emotional  attachment before engaging in sex, they may simply be seeking pleasure rather than trying to bond and build a relationship. These transgressions set the stage for codependent behaviors and anxious attachment for the borderline personality type.

There is a symbiotic relationship between Narcissus and Echo, and because of it’s predatory relationship, it is one that cannot be sustained long term.  A relationship with individuals showing marked narcissistic traits will require others who will provide them with an ongoing narcissistic supply. Individuals with borderline traits/disorder may enter into relationships with a great variety of people, though at the core there is a tendency to choose situations in which unrequited love will be the outcome.  For those with NPD, a lack of emotional connectedness and closeness results in a lack of long-term relationships. Both individuals with traits of Borderline Personality Disorder (BPD) and Narcissistic Personality Disorder (NPD) engage in maladaptive behaviors resulting in harmful relationship outcomes.

In the film Listen Up Phillip, a narcissistic writer, Philip, played by Jason Schwartzman is involved in a parasitic relationship with his girlfriend Ashley, played by Elizabeth Moss. The relationship seems unfathomable considering how little he actually cares for her, and yet still needs to harbor the illusion of being humanly connected.  Philip enters and exits Ashley’s life throughout the film. On one occasion he suddenly leaves her for several months to focus on writing in the country while casually saying,  “I hope this will be good for us, but especially me,” while waltzing out the door.  The film shows Ashley's emotional roller coaster in the wake of finally deciding to ban Philip from her life for good. At first averse to the notion of being actually alone, as opposed to figuratively alone, Ashley experiences depression and disinterest in her work. When she finally comes out on the other side of their break-up, which Philip deems merely a temporary separation while he accepts a teaching job at a college upstate, she is stronger than ever and finally able to cut ties with Philip. This may be the most redeeming aspect of the film - the fact that at least one person experiences a metamorphosis. 

Narcissistic Personality Disorder describes individuals who consciously feel superior to others (at least this is what they tell themselves). Individuals struggle with a strong discomfort with feeling vulnerable and a lack of empathic connection with others.  Narcissists choose their lovers based on whether the person enhances their self-esteem.  This ongoing need is referred to as a narcissistic supply.  As this need continues, there is little to no incentive to wait to get to know a person better.  The things that attract a Narcissist are not strong redeeming character traits or compatibility, but may focus on if a person has high status in their eyes. The experience of loving an individual with NPD can be emotionally traumatic and confusing. Since their real interest in relationships are shallow, they often leave relationships as suddenly as they began them.  

Borderline Personality Disorder is a complex disorder and involves many aspects of the human psyche. The poor relationship one has with themselves is mainly due to a combination of their upbringing and interactions with others at an incredibly early age and their genetics.  With borderline personality disorder, the individual fears abandonment in close relationships and cycles through an anxious attachment style and extreme emotions.  The emotional intensity surrounding this fear can lead to inadvertently enabling narcissistic behaviors in those for whom love, admiration, validation, attention, and empathy are sought.  The fear of abandonment is irrational for those with BPD but when they engage in relationships with individuals on the narcissism spectrum they may find these fears to be valid. This is especially so when they form quick strong attachments and resist any information that suggests that they should detach because someone may be an inappropriate mate. The idea of detaching brings up their underlying fears of abandonment, so they find reasons not to leave. Narcissistic and Borderline individuals want different things in relationships. Narcissists want continuous self-esteem enhancement and Borderlines want continuous unconditional love.  

If you are in a toxic and co-dependent relationship, and find that you are enabling narcissistic or borderline traits in another, it’s important to start protecting yourself:

  • Don’t be quick to be swept away by quick, intense romantic attachments without looking very closely at the other person’s real personality.  
  • It’s important to be honest with yourself and evaluate if this relationship is mutually empathic. Is there an equal emotional give and take? Does this person see you as their equal and not a source of narcissistic supply or an unhealthy codependency?
  • Know who you’re dealing with.  Some individuals with personality disorders may react with anger, resentment, or revenge when you confront them. Challenging their narcissistic supply or disagreeing with them may become a narcissistic injury, which may illicit a strong negative reaction.
  • It’s important to be confident, and to assertively set clear boundaries. 
  • Calmly and carefully explain to them how their behaviors and words affect other people.
  • Respectfully ask them to put themselves in the place of the other person.  
  • Help them to see behavioral expectations that should be obvious. 
  • They are capable of intellectually understanding their behavior outcomes, but this is very difficult for them. It is hard work and requires a firm and serious life commitment and the tenacity to openly discuss insecurities with a partner and therapist on an ongoing basis.

Listen to your intuition and refuse the temptation to overanalyze and diagnose. If you suspect someone is being abusive towards you and you are in a situation that is potentially dangerous, be proactive and take the steps to remove yourself from this relationship. Refer to a mental health provider and other qualified professionals to help you identify and work on changing your own self-defeating behavioral patterns.  And in the process of healing ask yourself,  what made you put up with the abuse in the first place?

References:

  • Alloway, T., Runac, R., Qureshi, M., Kemp, G. Is facebook linked to selfishness? Investigating the relationships among social media use, empathy, and narcissism. Soc. Netw. 2014;3:150–158.
  • Association between physiological oscillations in self-esteem, narcissism and internet addiction: A cross-sectional study  http://www.psy-journal.com/article/  S0165-1781(17)30425-0/references
  • Levine, Amir, and Rachel Heller. Attached: the New Science of Adult Attachment and How It Can Help You Find - and Keep - Love. Jeremy P. Tarcher/Penguin, 2011. 
  • Lewis, Thomas, et al. A General Theory of Love. Vintage Books, 2001. 
  • Bender, L. (Producer), &. Perry, Alex Ross. (12014). Listen Up Philip  [Faliro House Productions]. United States.

Nadine Burgos is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Self-Compassion: Recognizing Our Common Humanity

By Sarah Spitz, LMSW

Back around Valentine's Day last year I did a post on self-compassion as a reminder that we, as much as anyone else, are deserving of love and kindness. I referenced the research of Dr. Kristin Neff who has identified three elements of self-compassion.  My last post focused on the first element of self-compassion: "self-kindness vs. self-judgement." This means that we react to ourselves with kindness and understanding when we are confronted with personal failings. As Neff says, "self-compassionate people recognize that being imperfect, failing, and experiencing life difficulties is inevitable, so they tend to be gentle with themselves when confronted with painful experiences rather than getting angry when life falls short of set ideals."  

Today I wanted to highlight the second element of self-compassion: "common humanity vs. isolation."  Often when we feel that we have failed or made a mistake, we may feel very alone and as if we are the only person to have experienced this situation. I'm sure most of us have said some iteration of this phrase to ourselves: "I can't believe I made this mistake - I'm such a failure." We beat ourselves up and it can feel as though we are the only person flawed enough to have done what we did. How isolating does that feel?! 

A key part of self-compassion is recognizing that making mistakes is part of being human.  As Neff says, "suffering and personal inadequacy is part of the shared human experience – something that we all go through rather than being something that happens to “me” alone."  Below are two exercises to help cultivate this element of self-compassion:

Self-Compassion Journal
Neff offers journaling exercises for each of the elements of self-compassion, and for "common humanity vs. isolation" she suggests writing about how our personal experiences are connected to the larger human experience.  If you find yourself being self-critical about a mistake you made that day, take the opportunity to view it through a more universal lens.  Write about some of the factors outside of yourself that led to what happened, and also remind yourself that you are not alone in this feeling/situation. For example, write statements such as "other people have felt/feel this way" and "it's human to make mistakes."  

Loving Kindness Meditation
There are many versions of the loving kindness meditation out there, but one of the essential features is that it involves sending compassion to both ourselves and others. Inherent in that is the idea of common humanity—that we are not alone in the experience of suffering. You can either listen to a guided meditation or craft your own version that resonates with you. Below are some examples: 

 

Resources:

 

Sarah Spitz is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Hope Through Positivity (While We Wait for Science to Catch Up)

By Dan Perlman, LMSW

Clinical depression, or Major Depression, is characterized by “persistently depressed mood or loss of interest in activities, causing significant impairment in daily life.”  Affecting nearly 3 million Americans each year, we’re only now beginning to understand the roles stress, trauma, genetics, and neurology play. From a scientific perspective, certain areas of the inner brain are believed to help regulate mood, although scientists' current understanding of the neurological underpinnings of mood is far from certain.  A study published in The Journal of Neuroscience in 2017 found that of 24 women who had a history of depression, the hippocampus "9% to 13% smaller in depressed women compared with those who were not depressed.” 

While no one size fits all, and many medications provide meaningful benefits, it seems apparent that talk therapy remains in the forefront of treatment.  The two most commonly used for depression are cognitive-behavioral therapy (CBT) and interpersonal therapy. Just talking and thinking seems to help relieve displaced anger that has been misdirected inward at oneself.

Many clients share a feeling of "emerging from a dark hole” after a positive talk. They say that life out here is “brighter and lighter," that a pressure has been taken off their heads, or that “the pushing down and weight on my shoulders has gone away.”  Often this occurs without medication, brain scans, or any sudden financial windfall to assign as catalyst. Sometimes they’ve just come in talk to someone and gone out feeling less alone. 

Clients' stunned reactions and almost confused sentiment at the lifting clouds is breathtaking.  In essence, they experience the lifting of depression, and I imagine their prefrontal cortex is springing back to life.  When they refer to the hole of depression having "moved over there” or for some, completely disappearing, it is powerful, moving, and almost spiritual to witness.  At this point in recovery I tend to believe something outside of our awareness is happening — call it love, spirits, or karma.   Sigmund Freud once wrote that psychoanalysis is “in essence a cure by love.” When done effectively,  psychoanalytic therapy shifts and eases the blocks that stop us from loving or being able to be loved. 

Being someone who believes in something more than we can see, I occasionally look toward those who can tie our craft to even broader ideas. This brings me to a sermon by Joel Osteen (He’s the pastor who fills the 15k seat Compaq center in Houston weekly and has millions of followers worldwide). Recently I read that he said, “Choosing to be positive and having a grateful attitude is going to determine how you’re going to live your life!”  I think he’s right, and that positivity is not only infectious for our clients, but it provides the love that Freud believed can become curative. 

References:

Dan Perlman is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

What to do When You're Feeling Overwhelmed

By Bethany Nickerson, LMSW

Lately I have had several clients and many of my friends mention that they are feeling overwhelmed, and I can definitely relate. Between work, chores, family responsibilities, exercising, and trying to still have time for a social life, it's easy to feel like you're always a little behind. Here are a few things I have found that really help me when I feel myself getting anxious and caught up in racing thoughts about everything I need to do:

  1. Do some deep breathing. My favorite is alternate nostril breathing. It helps me to get out of my anxiety brain and back into my wise mind. You can find a great tutorial from The Art of Living.

  2. Move your body. Do some stretching or go for a nice long walk.

  3. Brain Dump. Take a few minutes and write down everything that is bouncing around in your brain. All of your worries, anxieties, and things that you want to get done. Then take a red pen and cross out anything that you have no control over. This will help you focus your time and energy.

  4. Prioritize tasks. Take the remaining things on your list and figure out which tasks are time sensitive. Number things starting with the most critical.

  5. Keep a gratitude journal. Every day write down 3-5 things that went well or things you are grateful for. When you are feeling down or overwhelmed look back in your journal. This is one of my favorite tools as it gives me perspective and helps me to focus on the positive and what I am doing right.

Bethany Nickerson is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.