Month: October 2020

Not About Pedicures

Ellis1 Comment

It’s Not About Pedicures

I’m quite alarmed by the way that we treat self care, both for ourselves as mental health professionals, but also for our clients. We think about self care the way we think about hunger or sleep – we let ourselves get way overstressed and then we thinking that dropping off the plane in a withdrawal state or going on a self-indulgent binge is the way to somehow repair this.

(Without dismissing the importance of the basic physical health aspects – hydration, good nutrition, regular exercise, adequate sleep…) I’d like to propose a way of thinking about self care that is largely grounded in Csikszentmihalyi’s concept of Flow. The short explanation of Flow, if you’re not familiar with it, is that “zone” we get into when we’re involved in an activity that is just the right balance of challenge with our skills. It’s a balance, because if we’re engaged in things that are too easy, we get bored. If we’re engaged in things that are too difficult, we get stressed/anxious. If you’ve been in that zone, you know what I mean. In that zone, you don’t really run out of energy – the energy just seems to self-replenish.

 

 

I believe in our clinical work, we often get ourselves (or find ourselves) out of balance.

 

We take on too much – too many clients, too long of days, clients who are legitimately outside our boundaries of competence but we don’t want to admit it, expecting to have the same therapy-stamina as the most productive person in the office.

 

Or we take on too little – get into a therapeutic rut and don’t challenge ourselves to build new skills, we are in an overly systematized job and function as automatons rather than clinicians.

 

Sometimes, it’s that we feel we have no control – we’ve given up our autonomy to a harsh internship director for the sake of getting hours (oh, how you’ll regret this!), we’re so burdened by rules and paperwork that our actual clinical work is only a handful of minutes per hour or day.

 
And sometimes, it’s that we know the work isn’t meaningful – we can see that clients aren’t improving, our setting won’t allow for the care clients need, etc.

 

Real talk: if you are exhausted at the end of a perfect clinical day – engaging, moderately challenging clients with a diversity of experiences and concerns who you can have some degree of independence in working with – this might not be your calling. But I’d say that’s probably not most of us. And once you become aware of the ways your clinical work is pulling you out of Flow, you can begin to correct it!

 

Comment, please: Which way do you find yourself leaning out of Flow? How can you see this also working in clients’ lives?

 

 

 

 

Not Just For Decoration

EllisLeave a comment

Not Just For Decoration

I keep lots of things in my office that are not just for decoration. You might have read the post on the “useful treasures” box. This is sort of an extension of that idea, but things that I keep out in the office, either because they’re pretty, or because it’s useful for clients to see them, or because they don’t fit in the box.

 

  • Singing bowl
    • I keep a Tibetan singing bowl in the office partly because it’s just simply gorgeous. I also like to have it available to use with clients when they are learning meditation (of course), but also sometime as an “arriving” or “departure” moment, especially for client who are doing tough work, like trauma work. It can help them to have a minute to get settled in, check homework, do updates and then something to mark the transition clearly. Doing so at the end of their “deep work” also helps them to wrap up and transition back into the “real world.” I also use it sometimes when I need a super fast grounding moment between sessions.
  • Long feather for balancing
    • I have two ostrich-style feathers that sit in a cup on my desk. They’re pretty but not ostentatious and they have long, un-feathered stems. I typically have clients try to balance the feather by the stem on one fingertip. This is great for younger clients with ADHD to practice active mindfulness, it’s nice for couples as a way to not get too worked up during conflict discussions, and it’s good for many clients who need a “distractor” while they access and speak about difficult material. I’ve also let clients use the feather-end to create a sensation that they can focus on, in a DBT distress-tolerance kind of way.
  • Highlighters in many colors
    • Highlighters can do all the work of markers, don’t dry out as quickly, and obviously can be used over text as well. I use highlighters in a million ways – I’ve even printed out a list of erotic-story-words during session for a very shy client to read with her husband so she could highlight the words she feels most comfortable with him using without having to say them out loud! Also, along with the bubbles and blank paper (in my useful treasures box), highlighters are a great distraction for kids who randomly show up.
  • Phrenology bust
    • Actually Charlton (pictured above) doesn’t technically live in my office anymore, now that I share an office. But when he did, I liked to use him as an example of how we can hypothesize, gather data, and update our theories – in psychology, in therapy, and individually.
  • Jar of rocks
    • I like to keep a little clear glass jar in my office, filled with random rocks. It’s unobtrusive, and clients rarely mention it. But I like to have the rocks in case I need something to give a client as a transition object (e.g., a client with strong BPD who will be worried about abandonment) but I don’t want to give them something I actually need, use, or care about. I also occasionally give them to client who are working on habit control, as a “holder” for their motivations – so that when they are in a tempting situation, they can hold the rock. And, it’s fun to just always be on the lookout for pretty or interesting rocks!

 

Comment: What other useful things do you have in your office? Have you “pulled a MacGyver” and used something in your office for an unintended but epically useful purpose?

 

 

 

 

Connect These Dots

EllisLeave a comment

Connect These Dots

Connect these dots. Go ahead. Geez, at least imagine doing it!

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

Chances are one of these pictures is something like what you imagined as “the way” (or “your way”) to connect the dots, and some of them aren’t. Some might have surprised you, in a delightful way. Some of them might even feel…. wrong to you. ::Gasp!:: This isn’t a mind blowing concept – people connect dots in different ways. They perceive the same situation differently. This is just another way to demonstrate this for clients. I like it because it’s experiential and also relatively non-threatening (and super easy – you don’t need anything but what you normally have in your office to do this) The Horse & Frog pictures exercise is another way I like to do this.

I’ve recently taken this exercise to the next level in a fun way…

I made this picture (it was much harder than I expected to find the right “star level” for this activity, especially royalty free) and I printed it as a photo multiple times. I keep them in my office along with 3-4 of the metallic sharpies. I hand one photo and one sharpie to each client and tell them, “Imagine you are priest-king of an ancient civilization and create a constellation.” They do, and they obviously create different constellations. One of the bonus-features to this activity is that they typically use most of the same larger stars, but they also use different medium/background stars to complete their constellations. That gives us a way to talk about connecting the dots differently, but also things like cultural background, personal history, and perceptual differences in how they construct a narrative.

 

Comment below – I’d love to see the other ways you connect these dots, or ideas you have about bringing this concept into session! And definitely feel free to steal this!

 

 

 

 

PreposterousQuotes – BeYourself

EllisLeave a comment

I’m sure they meant this to be nice, but I don’t think they read it.

What a horrible reason to be yourself! Not that you are infinitely unique and valuable. Not that you have tons of creative and productive potential that no one else has. Literally, this says it’s too bad you couldn’t be any one else (implication – anyone else would be better), so you might as well be you (that’s the only choice you’ve got, so settle for being you). YUCK! 

Dr. Seuss does it better: Today You are You, that is truer than true. There is no one alive who is Youer than You! 

Carl Rogers does it WAY better: “People are just as wonderful as sunsets if you let them be. When I look at a sunset, I don’t find myself saying, ‘Soften the orange a bit on the right hand corner.’ I don’t try to control a sunset. I watch with awe as it unfolds.”

 

 

 

 

 

 

Couples Metaphor – Yoga

EllisLeave a comment

Yoga for Couples

Here’s a great relationship metaphor… but be aware that it might not work as well for clients who have no experience with yoga!

 

What about thinking about your relationship the way you think about your yoga practice?

 

  • 1) Set your intention. When you’re tuned in to your practice, mindfully present, your practice goes better. You know it does. When you’re just there because it’s Tuesday morning, when you’re checked out because you have a busy day ahead, when you’re there even when you know that sleeping in would have been healthier for you… your practice suffers.
    • Whether this is about the initiation of a relationship, or about a communication within a relationship you have, being mindfully aware of what you are entering into is crucial.
  • 1a) Be honest about that. It does no good to set your intention to “peace” during your yoga practice when you know you’re too worked up, or if it’s a Hot Power Flow class! You don’t need your intention to be the same as anyone else’s, and certainly not “better” than theirs (as if that’s possible).
    • In your relationship, there’s no point in setting an intention you “should” have, rather than the one you actually do have. Those “shoulds” might come from you, your history, your facebook feed, wherever. But it’s worth it to be honest with yourself about what you’re looking for.
  • 1b) Change if necessary. In addition to being honest, you want your intention to be healthy. If you’ve honestly reflected and your intention for your practice is to look better than the person next you, or to make and hold a pose regardless of your injuries… well, that’s why we set our intentions early in the practice – so we don’t waste all of that time and effort chasing something harmful.
    • Likewise, if you can tell that your intention for the relationship – or the argument – is just to win, to be “better than,” to have something you know will be nice now but damaging in the future… it’s time to rethink. Before that argument starts, preferably.

 

  • 2) Be gentle. We know that gentle stretching increases flexibility safely and – because it doesn’t cause damage – it doesn’t injure us and set us back. Similarly, gently breathing through discomfort and gently encouraging yourself to build strength go a long way toward not just finishing your practice well… but showing up the next day. Being a harsh critic has no place in yoga.
    • When communicating with your partner, always err on the side of gentleness. Clarity is important, yes. But more important is that additional damage doesn’t occur, setting the conversation back further. Going slowly, staying together, breathing through discomfort, gentle encouragement… these are powerful relationship changers, even though they aren’t dramatic.
  • 2a) Don’t expect the same “performance” every time. Every day and every practice is different. Although we tend to grow in healthy ways and make sustainable gains in yoga, what was easy yesterday may be difficult today. For many reasons, a joint may be stiff or a muscle sore.
    • Likewise, there are always multiple factors working in and around us in our relationships. While you can expect pleasant changes over time (in the context of healthy communication and such), it’s a bad idea to “microjudge” yourself or your partner. No need to hold yourself strictly accountable to being exactly the same all the time. 

 

  • 3) Don’t rush to the end. There is no “end.” There’s no winning in yoga. There’s no “being right.” It’s not a competition. It’s a practice.
    • Work slowly and gently, with the process in mind, more than the outcome. Too often, we’ve already decided the only acceptable outcome for us in advance, but then there’s no space to grow.
  • 3a) Don’t work on everything all at once. Building strength and flexibility in one area certainly benefits other areas. You’ve probably been to a yoga class that emphasized “twisting” and on another day emphasized “warrior strength.” And while that might mean that the overall
    • You needn’t cover all the

 

  • 4) Namaste. During the whole practice (and at the end), remember to honor the divine light within you, your instructor, and everyone present. It helps to maintain the growth-mindset rather than the competition mindset.
    • At the beginning, at the end, and whenever you need to in the middle of your communication – remind yourself (and maybe your partner) that this is a fully alive human being, deserving of love and respect. Remind yourself that you are, too.
  • 4a) End with peace. No matter what happens during practice, whether your legs were shaking in crescent, you fell out of tree pose, or anything else… savasana is always there.
    • Sometime when you aren’t in conflict, work out a peaceful place for yourself and your partner. Words you can say to reassure one another, something you can do together, or a place you can literally go that is “sacred” and set apart, that doesn’t involve conflict. Then, you always have something to look forward to. Even if that isn’t possible, make sure you have that for yourself, so that you can rest and recover… and come back the next day.

 

Double Triple Bonus points if you get clients to attend yoga together to enhance the metaphor!

Comment below: This metaphor seems endlessly rich to me! How can you contribute to it?

 

 

 

 

Affirmations

EllisLeave a comment

Affirmations

I won’t date myself by referencing the Saturday Night Live skit… well, what the hell, sure I will. It’s too classic. “I’m good enough. I’m smart enough. And doggone it, people like me.” Ah, thanks, Stuart Smalley.

Let’s talk about positive affirmations, and how to do them well.

    • Make them short and punchy. Your inner critic tends to have the vocabulary of a 6th grade bully, if you’re lucky. Your inner yoda/inner therapist/inner big sister/etc. can’t compete with that neurologically if it takes you a paragraph to say something meaningful and kind about yourself.
    • Make them accurate and defensible. No rainbows, ponies, or bullshit. Do the work of figuring out what the good things about you actually are. Make sure you have evidence, even though you won’t go through it every time (see #1). Along these same lines, don’t predict the future. Definitely replace the pop-psyc “affirmations” like “Everything will work out for me” and “I am a winner”!
    • Include your agency. There are many things you can do that you don’t do all the time. This is really helpful when you feel as though you’ve run out of the “I am ________” variety. Consider things like “I can make healthy choices” or “I’m able to hear my inner wisdom when I give myself the chance.”
    • Format them positively. This one you probably know – an affirmation should contain only positive language. This means that “I am attractive” works better than “I’m not ugly.” We want to avoid “lighting up” the parts of the brain that compete with the messaging we want to strengthen. “I’m not ugly” lights up the “ugly” networks, whether we want it to or not. So be careful with phrases like “I’m not…” or “I won’t…” or “I don’t have to…” or “I will stop…” etc. (While you’re at it, avoid language like “should” and “ought”!)
    • Check your language. Affirmations work best when they are something that becomes automatic and unconscious with exposure. So, it’s important to treat your language as carefully as hypnotic language – watch out for metaphors, descriptors, and turns of phrase that your unconscious mind may process concretely rather than abstractly (“I am a diamond; it’s time for me to shine” may bring up different associations subconsciously like hardness and impenetrability), or partially based on phrasing (“It’s easy for me to tune out the negative” can become “It’s easy for me to tune out”). This also mean things like not using the word “try” (because it implies failure at the concrete level) and words with more than one meaning like “stunning” or “pretty”. Also, be mindful of homonyms (word that sound the same) – like “a lot” (allot), peace (piece), know (no), etc. (Or even nearly the same, especially if you’re recording affirmations for a client – be mindful of your vocal differences!)

 

Bonus idea: When you’re recording the affirmations for clients, say each one out loud, and then pace yourself by saying it again in your head before you move on to the next one – this gives them time to repeat each one silently or aloud,  in their own voice.    

Comment below: Do you have any great examples of your favorite affirmations to share?