Hope on the Horizon

Hope on the Horizon

By Elizabeth O’Brien, LPC-S

Last Monday evening, June 15th, restored my faith in our country. No sooner did the Supreme Court rule against discrimination of LGBTQ individuals in the workplace than we were regaled, near sunset, with the most spectacular rainbow fanning across the big Texas sky. From my back deck, I suddenly noticed that the light outside seemed odd, softer, and when I looked up, there it was: the rainbow of rainbows.  next-door.com exploded with neighbors urging neighbors to rush outside and witness it. I listened happily to the exuberant voices of the families in our cul-de-sac wafting from their decks and porches.

It was almost as if God was celebrating this monumental victory with us. The rainbow, after all, is traditionally the symbol for hope, dreams, fulfillment and happiness. And in 1978,  it also became the symbol of LGBTQ pride when gay activist Gilbert Baker created the rainbow flag. Each color stands for something: pink for sex, red for life, orange for healing, yellow for sunlight, green for nature, turquoise for magic, blue for serenity and purple for spirit. Later that same week, the Supreme Court  ruled in favor of DACA, allowing the Dreamers yet another breather. 

That rainbow was a gift, not only in relation to the Supreme Court LGBTQ ruling (and a harbinger of the DACA ruling later that week) but also as a symbol of hope in terms of the pandemic, the battered economy and the Black Lives Matter movement. 

In an instant, our spirits were buoyed and we were all in awe. Too often, we ignore the spiritual dimension in our world. That rainbow made me realize that we humans are not really in charge here. 


I Can’t Breathe

“I Can’t Breathe”

By Elizabeth O’Brien, LPC-S (Licensed Professional Counselor-Supervisor)

I’ve been thinking a lot about George Floyd. His plaintive cry of “I can’t breathe”—when Minnesota policeman Derek Chauvin knelt on his neck for more than eight minutes, with two colleagues restraining his back, resulting in his murder—speaks volumes. It has become emblematic of the state of our world, and particularly of our country, at this moment in history. It has become a rallying cry.

Black Americans have not been able to truly breathe in our culture since their ancestors were brought here as slaves. Even after they were emancipated, and even after the Civil Rights movement, they have been  treated as “less than” and have had to compete at a great disadvantage, not only with white Americans but with other ethnic groups. Black Americans frequently come under suspicion when they are simply going about their lives. Young Black men populate our prisons in disproportionate numbers, many for minor drug charges. White men, meanwhile, often walk free for the same offenses. And mistreatment and even murder of Black individuals by the police have gone largely unchecked.

Victims of COVID, as the illness takes hold, also struggle to breathe. The pandemic has been especially cruel to Black Americans and Latinx who, largely due to socio-economic factors, suffer more from co-morbid conditions. Those of us who haven’t fallen ill are struggling to breathe behind masks when we venture out and then metaphorically when we are sequestered in our homes.

And more and more of us are struggling to breathe under the oppressive regime of Donald Trump, a power-hungry narcissist who is incapable of empathy and therefore of functioning as a true, moral leader. He has systematically suffocated our democracy while posing as a “Christian,” most recently by holding a Bible upside down during his ridiculous photo op in front of the St. John’s Episcopal Church in DC. This was a publicity stunt for which his crony, the notorious bully, Attorney General William Barr, ordered the troops to use pepper spray and fire rubber bullets at a peaceful group of protestors in order to disperse them. 

I am from Memphis. I was in the fifth grade at Idlewild Elementary School, a public school in our modest neighborhood, when the Civil Rights Act was passed. Public schools were integrated. By the time sixth grade rolled around, my fearful parents had enrolled my sister and me in an all-white private girls’ school which they could ill afford. Later, in 1968, Martin Luther King was assassinated in my hometown. The city exploded around us and we were locked down under strict curfew. All throughout my teenage years, I argued with my parents about racism and their stance toward “colored people.” I knew by the time I was 15 that I would escape Memphis—the Deep South—and never look back. And at 18, I did. 

Now I am a senior citizen, wondering how I can make an impact, besides donating to the NAACP Legal Defense Fund, the Democratic Party and other social justice causes. I want to march with the protestors but I fear for my health. So I am sheltering in place, and I’ve committed myself to finding my mission in this movement. Above all, I am listening.

COVID Journal 4/8/20

COVID Journal 4/8/20

I never know how I’m going to feel when I wake up in the morning. Some days are dark, ominous—even when the sun is out—and others, like today, are more promising. We dodged a bullet in our family when our daughter and her husband, who came down with the virus in March, recovered. They were very sick for two weeks with all the classic covid symptoms, a hospital bag ready by the door, but they emerged intact. We are deeply grateful; grateful, too, that our youngest son and his girlfriend—who hung out with them when they were likely contagious—didn’t contract the virus. They are all young and athletic, but we know now that youth and fitness are no panacea.

I realize that I monitor the news too much; since we are living through unprecedented times, it’s hard not to pay attention. I try to stick to NPR and PBS, which avoid the drama of the major outlets and offer a balanced perspective. Still, even PBS news anchor Judy Woodruff seems worried.

We are worried, too: for our children, young adults, who have finally gained career traction, our extended family, our vulnerable friends with various medical conditions, and especially Gran, 92, my otherwise healthy mother-in law, who lives in a nursing home nearby. Already, at least two employees and one resident have tested positive. We haven’t been able to visit her for several weeks, though we ventured out one day to wave to her from the parking lot; she was stationed in her wheelchair at a second-floor picture window after we asked an attendant wheel her there. 

It’s scary enough that our health is in danger…we have to fret, too, about our economy crumbling. Nursing homes are expensive, as are our own lives, with mortgages, taxes, student debt and other bills. The prospect of losing income now is frightening, indeed. 

My higher self “catches” these thoughts, replacing them with happy ones: more grandchildren in our future; a more spiritual, resilient perspective; a new world, humbled and changed for the better. And I am very thankful that most of us in our family have been able to work remotely, though we have all lost some clients.

It IS deeply comforting that we are suffering through this together—as a country, as a world. In our neighborhood, at least, there is great solidarity: neighbors helping neighbors, families strolling outside and saying hello, respectful social distancing, lots of dog action. When we were unable to find Clorox wipes at any store or even online, our neighbors on nextdoor.com rallied to help, offering to leave canisters on their mailboxes or porches. We had so many offers we had to turn most of them down. 

Sometimes it takes a crisis to wake us up to what is truly meaningful in our lives: our families, friends, health, jobs. As a nation, we’ve been through tough challenges before. But this time, we’ve been stopped cold in our harried, individualistic American tracks and forced to contemplate our collective souls.

COVID Journal 4/3/20

My husband Michael and I begin the days normally: coffee, smoothie, 3-mile dog walk. Only the  walk is different than in pre-pandemic days, in that it’s the morning’s main event and one of 2-3 long walks we take in the ‘hood to keep from going mad. Mind you, we’ve had to “borrow” Jamie, the chocolate Lab, for the purpose. She is technically my son’s dog, though I raised her as a pup until he graduated from college. But at the beginning of this covid, shelter-in-place mess, we lost our beloved Bichon, Buffett, just two days shy of his 18th birthday. He was a 20-pound, tail-wagging fixture, a proper family member. When the kids were young, I  talked for him in a special hoarse voice, saying silly things like his favorite saying: “If looks could kill, you’d all be dead by now!” He was handsome, indeed—with his soft brown eyes and powder-puff Afro— and he knew it. 

As he aged and lost functioning, he became unable to walk or do much of anything but sleep and moan in pain. I spent the bulk of my time caring for him: carrying him to his favorite grassy knoll to do his business, bathing him gently—which made him feel better—and taking him with me to work or to run errands. He loved riding in the car, even toward the end. 

Losing him left an awful hole in our lives. Appropriately, it was Friday the 13th of March. Our faithful veterinarian Brent came to our house and encouraged us to give him his favorite treat—Blue Bell homemade vanilla ice cream—before putting him to sleep. The family gathered ‘round, said our goodbyes as I cradled him in my arms. Our daughter, Owen, now 31, repeated his favorite saying in his characteristic hoarse voice. We cried. Brent administered propofol, the Michael Jackson drug, to relax him before giving him the lethal drug. It was a peaceful passing, his beard damp with a swath of melted ice cream.

A week later, I asked Jesse and Amanda if we could take Jamie for a while, to comfort us. Our house was empty, desolate. Since they recently had a baby boy, lending out Jamie lightened their load (or so I told myself). It was only with Jamie in tow that I could steel myself to drive to the vet and pick up Buffett’s ashes and ceramic paw print. She understood; I couldn’t have done it without her.

This pandemic has been a boon for family dogs. Suddenly, everyone is home, hanging out. Dogs are getting lots of walks and much more attention than usual. But there are many dogs who’ve been dumped at shelters; some owners have lost their jobs and incomes and can’t afford to keep them. Many dogs are being fostered temporarily; others, surrendered. This is a good time to get a dog, either short- or long-term, if you’ve been wanting one.

For now, I’m grateful for Jamie. I know I’ll have to give her back one day, but by then, maybe I’ll be ready to risk my heart again.

The Spiritual Power of Depression

The Spiritual Power of Depression

By Elizabeth O’Brien, LPC-S

“Depression Hurts.”

This clever tagline was used for years by a pharmaceutical company hawking a particular anti-depressant, or SSRI, and the medication in question allegedly ameliorated not only the despair and fatigue of depression but also the actual physical aches and pains that often accompany it. Many patients swore by it, still do. In fact, there are a host of such SSRI and other anti-depressant drugs on the market that have helped scores of people get over the depression hump.

No one likes to be depressed. Yes, depression can, indeed, hurt—mind and body. And it’s emblematic of our instant-gratification culture to do something to feel better right away: take a drink, smoke a joint, pop a pill, find a distraction—ANY distraction. We’re supposed to be happy, right? Depression, it seems, is simply not acceptable. 

I try to offer clients another perspective. Perhaps their depression is a wake-up call. I ask them: What is your depression trying to tell you? Jungian therapist and author James Hollis says that when the same angst keeps coming up again and again, it’s “the soul knocking on the door.”

Depression and anxiety come with the human condition. We all confront painful and difficult times in our lives when we feel low, or anxious (the flip side of depression), and not like our best selves. This is normal. What’s most important is to explore the depression, to sit with it, to try and move through it, and in so doing gain valuable insight about the choices we are making and the lives we are leading. Chances are, there’s either a situational reason or, more likely, an unconscious imperative that is not being addressed. 

Jungian therapist James Hollis, in one of his many books, Swamplands of the Soul/New Life in Dismal Places, writes:

“It takes great courage to value depression, to respect it, not to try to medicate it away or distract ourselves from its misery. Down there is potential meaning, split off from consciousness, but alive, dynamic. Although a depression robs conscious life of energy, that energy is not gone. It is in the underworld, and like Orpheus who goes down there to confront, perhaps to charm, the lower powers, so we too are obliged to go down into the depression and find our soul’s treasure.”

However, and this is an important caveat: Clients who are deeply, clinically, depressed and/or who have a genetic component to their depression, likely have dysfunctional brain chemistry; they have a medical illness. They can fall into darkness precipitously, dangerously, and get stuck. Once there, they don’t have the energy, or functionality, to do the necessary therapeutic work. They need medication to “bring them up,” to stabilize them enough to explore their issues and look inside themselves. 

In Darkness Visible, the writer William Styron describes his harrowing experience with clinical depression:

“The pain of severe depression is quite unimaginable to those who have not suffered it, and it kills in many instances because its anguish can no longer be borne.”

Owen Powell, LCSW, clinical director of Deep Eddy Psychotherapy in Austin, has witnessed powerful changes in seriously depressed clients who finally resort to medication. She says:

“For people in this category and others who have been endeavoring to independently bootstrap and white-knuckle their pain for years, deciding to take medication can be a tremendous gesture of self-love and self-compassion that can be as powerful as the medication itself. This symbolic gesture can even help them have more courage to ask for help and accept help from others.”

She goes on to say that for clients who aren’t interested in doing the critical therapeutic and spiritual work, taking medication as a superficial fix isn’t the answer.

“Taking medication to numb or ignore the pain is not helpful. It seems that medication, like everything, is about how you frame it, view it, interpret its meaning.”

Indeed, research bears out that the most successful treatment for depression is a combination of medication and psychotherapy.  

In my own practice and life, I’ve seen a number of people who begin taking meds during a dark period, with positive effect, then find it difficult to stop. Many, either out of fear and/or difficult side effects when trying to quit, continue taking them—for years, even decades. For clients who are not genetically depressed, living in such a medicated state can ultimately tamp down the motivation for looking deeply within.

Admittedly, it’s daunting, if not impossible, to navigate this journey alone. Medication or not, seeing a psychotherapist or joining a therapeutic group can go a long way toward healing. Journaling about one’s angst, according to research, is highly effective. James Pennebaker, psychology professor at The University of Texas/Austin, has found that  writing delves much more deeply into the unconscious than talk therapy. Pennebaker, who advocates journaling four times a week for 20 minutes at a time—as a regular discipline—has spent years researching the therapeutic benefits of writing. His findings also suggest that writing about emotions and stress can boost immune functioning in patients with such illnesses as HIV/AIDS, asthma and arthritis. And that keeping painful secrets can make people sick.

Expressing yourself through art, meditating, exercising, getting outside into nature and sunshine, eating a whole foods diet, staying hydrated, getting enough sleep and connecting with others can also bolster emotional and spiritual recovery.

Once stable, clients must explore not only life situations that are toxic or dysfunctional but also existential questions.

Are you being true to yourself? Are you on your rightful path—or one that’s been prescribed by others? Are you using your talents and abilities to contribute something to the world? Are you allowing yourself to love and be loved? Are you keeping healthy boundaries around yourself, yet allowing yourself to be vulnerable with appropriate people? Are you finding meaning in your life? These are some of the deeper questions that might plague us.

So first consider exploring the question: What is my depression trying to tell me? Sooner or later, we must answer the soul’s summons. To ignore it is to remain unconscious.

The Interestings

By Elizabeth O’Brien, LPC-S

I see a lot of clients who suffer from social anxiety. Many of them begin to isolate because of their discomfort.

When we deconstruct their social experiences, more often than not many clients report that they strive to appear interesting to others and hence spend the bulk of their social exchanges talking about themselves. This is a manifestation of their anxiety.

While we all have potentially compelling stories to tell, failing to attune to others can be tantamount to social suicide. Connecting to other people successfully requires reciprocity—something that’s sadly anemic in this age of virtual connection and social media. It’s an easy fix but simply doesn’t come naturally to many, particularly those who were not raised with secure attachment—who did not learn “mirroring” from birth—or young adults who have been weaned on digital communication.

Instead of working so hard to appear interesting to other people, the key to healthy interaction is to become interested in others. Expressing genuine curiosity about their lives, careers, families and interests paves the way for true reciprocity and ultimately, friendship, even romance. This is a hallmark of emotional intelligence.

How many times have you been at a party, cornered by a self-involved person who goes on and on about herself without asking you a single question about yourself? This should be a major red flag, and an excuse to politely move on. How much better does it feel when someone actually wants to get to know you…someone who’s looking for some common ground or who’s fascinated by your experiences?

There’s a trap on the other side, too. Some people deal with their social anxiety by keeping the focus exclusively on the other. By doing this, they hide. They don’t allow themselves to be seen. And since so many people—“the interestings”— need little encouragement to talk about themselves, the “hiders” remain safe, unexposed—and disconnected.

The truth is that unless we show ourselves—our human, vulnerable selves—to others, and attune to them as well, we will never make deep connections. And as neuroscience reveals, we thrive on connection and fail to thrive without it.

The Zen of Remote Coaching

By Elizabeth O’Brien, LPC-S

A year ago, my right hip had become so painful that I was reduced to walking with a cane. This was after months of limping, hoping the condition would resolve. I am an avid dog-walker, and log 2-4 miles in my neighborhood daily. I was desperate to avoid surgery, but determined to keep walking.

I had been hearing about a speciality gym in downtown Austin called Central Athlete, where several people I knew—many with injuries—worked out, extolling their physical transformations. This got my attention. I thought that perhaps through targeted workouts, I could strengthen the muscles and tendons around my hip and heal myself. But downtown was not convenient. I soon discovered, though, that Central Athlete offers a remote coaching option for clients who travel, prefer to work out at home and/or live too far from the gym. Perfect, I thought: There is a globo-gym five minutes from my house and, after speaking to CA trainer Justin Krause, I discovered he could set me up with an app on my phone that delivered my regular workouts, complete with imbedded demo videos. The deal included monthly, in-person consults with him.

To be honest, I wasn’t sure how this remote coaching idea would work for me since I would be on my own, in a sense, at my local gym. There would be no onsite trainer to push me. But I was game to try.

Before I began, I endured the notorious hassle of Austin traffic to drive to CA downtown to undergo a thorough fitness assessment with Justin. This entailed not only an extensive personal interview but also a physiological assessment with the high-tech InBody machine, which measures basic fitness—or in technical terms, “hydration, segmental lean mass and basal metabolic rate.” Justin then demonstrated how to do all the basic exercises he would be assigning. With years of experience and a Masters degree in Exercise Sports Science, he knows his business. He chose floor exercises, resistance band regimes and machines geared specifically to my hip situation; many exercises also focused on strengthening my core. He showed me how to use the CA app, and I was set. I was to work out four times a week at my local gym, visiting Justin at CA every month or two for a consult—in order to stay on track. Since I wanted a say in my exercise routine, and I am a lifelong swimmer, I asked Justin to include lap-swimming two days a week as part of my routine. He loved the idea: two swims per week (my local gym has a 25-meter pool) and two gym workouts. When I finished each workout, I was to note it in the app, detailing how much weight I used, how many reps and sets I completed—or the distance and time of the swim—and how I fared with the workout. This accountability, and instant connection to my CA coach, was key. Once I finished the exercises and sat down to make my notations, I felt a strong sense of accomplishment, even pride. This kept me motivated. I even kept a food log for six months, until new, healthier eating habits took hold.

To wit, CA’s remote coaching program isn’t just about the exercises. It addresses lifestyle, and includes comprehensive nutrition guidance and even some relevant life coaching. Diet, hydration, sleep and stress management hygiene were all included in the deal. As a psychotherapist, this holistic approach appealed to me. I strongly believe that physical fitness is the foundation for mental health—and I preach this to my own clients. I did have some apprehension, though, since I’m the kind of person who flourishes in a classroom. Taking Driver’s Ed online, for example, was a nightmare for me and took weeks to complete. Without an in-person instructor, not to mention the engagement of the other warm bodies in the room, I’m not necessarily on task. On the other hand, once I’m “launched” in a given initiative, I prefer guidance and mentoring to hand-holding, especially if I’m in a communal environment.

So I took the leap of faith and committed to remote coaching. Regular communication with my coach, as well as camaraderie in an arena around like-minded people, worked for me. It was beyond convenient, geographically and schedule-wise, and afforded me the autonomy I needed at this post-parenting stage of my life. And surprise: I loved the workouts! Almost every time, I fell into a kind of Zen, meditative state, often resulting in an almost effortless, “flow” experience. Therefore, I was grateful that I didn’t have an onsite trainer talking to me and assessing my every move.

Unfortunately, though, my hip did not improve. I felt great otherwise, but the cane was becoming another appendage. X-rays revealed a jagged hip ball and severe osteoarthritis. I sought second and third opinions and all the orthopedic doctors said the same thing: I needed a total hip replacement, sooner rather than later.

I was fortunate to secure Dr. Shelby Carter as my surgeon. He is one of the first surgeons here to perform the much less-invasive anterior total hip replacement, whereby the surgeon enters through a small incision at the front of the hip, pushing tendons and muscles aside instead of severing them, to perform the operation. Dr. Carter is considered the best hip and knee surgeon in Austin, and I am his poster child. Because I was fit before surgery, having done so much “pre-hab” as a CA remote coaching client, I was immediately up and about. I dispensed with the pain meds within two days, began physical therapy and started walking the dog within two weeks, albeit with the aforementioned cane—but only for balance and only briefly. Dr. Carter, who works with many patients who are overweight and unfit, was delighted. I ran into him at a restaurant a short time after surgery and danced a little jig for his benefit.

Soon thereafter, I returned to the gym. Justin made sure to titrate my workouts up or down accordingly, careful not to stress the hip. If I was having a hard time, we adjusted. And now, eight months later, I am back, only more so. The workouts have gotten more difficult, but I’m keeping pace. On the eve of my 65th birthday, I can honestly say that I am fitter than I have ever been—a bionic Boomer with a futuristic titanium-and-ceramic hip. And the solution that worked for me: remote coaching. It encapsulates the Zen of fitness, giving me the existential experience of autonomy, and leaving me calm, relaxed and, yes, enlightened.

The 3 Simple Hallmarks of Well-Being

What do we mean by “well-being?”
Dr. Martin Seligman, the positive psychology guru at the University of Pennsylvania, uses this term instead of “happiness,” as it’s a more accurate and less charged term describing the human state of relative peace and contentment to which most of us aspire. Imbedded in the term is self-compassion as well as both acceptance of self and the process of life as it is, warts and all. Happiness, on the other hand, is a rarer, more dramatic state that comes in bursts but generally doesn’t last. As we all know, a constant state of happiness is an unattainable—and unrealistic—goal. The human condition comes with certain angst, constant challenges and hurdles to overcome—which generally translate into painful opportunities for growth. We might be happy for brief periods of time, but life always comes back at us with a certain vengeance. With the world changing at such a heady speed, it seems that we can scarcely hold our footing.

Well-being, though, is possible.

Seligman uses the acronym “PERMA” to describe what he considers the five aspects of well-being: positive outlook, engagement, relationship, meaning and accomplishment.

It’s a solid prescription. However, we can make it even simpler—and we can work toward these realistic goals outside the therapist’s office. I believe that we can attain a pretty consistent sense of well-being through three initiatives:

Exercise—for body and brain
Family/social connection

It sounds easy. And it is, after a fashion.

Exercise, to start, should not be a dreaded obligation. It can be as easy and enjoyable as walking, provided you do it most days, beginning with a good 20 minutes. From there, you can increase the time/distance to a comfortable, sustainable length. All you need is a good pair of athletic shoes. While walking on a treadmill is fine in inclement weather, I would argue that it’s healthier to walk outdoors—when you can soak up much-needed Vitamin D, enjoy some beautiful, natural scenery and fraternize with neighbors. I walk mornings with my dog and often my husband, and it’s our golden time to hash things out. Since we’re not face-to-face, which is by definition more potentially confrontational, it’s a less stressful way to discuss important family and career matters, make plans and simply spend deliberate time together. For those who like dogs, a dog is an excellent, built-in fitness partner—a good argument for getting a furry companion. We live in a hilly, active dog neighborhood and often join our dog group up at the park on weekends for a group constitutional. This satisfies both exercise and social connection needs.
Beyond walking, the possibilities are endless: running, biking, yoga, Pilates, weights and resistance training, swimming, martial arts, rock-climbing…the list goes on. But I consider walking the foundation, regardless of whatever else you do. The point is to move your body in a powerful way every day. Exercise relieves stress, releases toxins, clears the head, speeds up metabolism and fosters self-esteem. It gets you out in the world. It’s a tangible accomplishment, on a regular basis. And when you are more fit, you have a tendency to eat in a healthier manner. If you walk three miles, or swim a mile, you probably don’t want to sabotage that effort with a pint of Ben & Jerry’s. By the same token, if you are well-exercised, you tend to stay properly hydrated and to sleep well.
Exercise is also good for the brain, and it also applies to the brain. Obviously, there are many ways to stimulate our brains: reading, writing, learning a language, doing something artistic or mathematical, playing bridge or other cognitively challenging games, taking a class, taking up a hobby out of our comfort zone. The point is not to spend too much time vegetating in front of the TV or computer, and getting sidetracked with social media.

Family and social connection are critical, and people are different in how much connection or intimacy they want and require. But, as both common sense and neuroscience bear out, human fellowship is a basic psychological and spiritual need. We are literally “wired to connect” and we do not thrive in isolation. Some people have a number of  friends and acquaintances, with their family as their core, while others prefer deeper one-on-one relationships. Significant others—romantic relationships—are part of this need. However, this may not be in the cards for everyone all the time; good friendships and even pets can help fill this void. But being alone, with only virtual connection to others, is not enough.
Making good friends takes some effort. Unless you live in your home town, complete with family and lifelong friends, you must take various initiatives to establish strong friendships. Finding a common-interest group (book group, chess or bridge club, Spanish conversation, politics, hiking, dancing, etc.), joining a religious/spiritual entity or volunteering are all helpful, so long as the experience provides repeated exposure to the same group of people. And speaking of brain exercise, camaraderie helps to keep our brains engaged. Countless studies have shown that people who are isolated are not as vital and do not live as long as those who are connected.

Finally, purpose. Cultivating a sense of purpose is often more critical after the first half of life, when we’re back to ourselves again. As Jungian psychotherapist James Hollis says, we spend the first half of our lives setting up our lives—getting an education, establishing a career, creating a family—and have the bandwidth for little else. While there is some sense of purpose in building the infrastructure of our lives, we are so busy during those earlier years that more deliberate and autonomous purpose is generally off the table. If we’re lucky, we have a job that contains purpose: teachers, nurses, doctors, certain nonprofits, etc. But many of us go to work to pay the bills. In the second half of our lives, according to Hollis, author of Finding Meaning in the Second Half of Life, we have more time and psychic space to listen for “the soul knocking on the door.” The old existential question, “Why am I here?” takes on a deeper urgency. However, I believe we all need a sense of purpose throughout our lives, whether it be school, career, parenthood, artistic or spiritual pursuits. The point is to invest deeply in something resonant, especially in an initiative that provides an opportunity for transcendence—for rising above ourselves for a greater mission.

In short, challenge your body and brain, make and cherish friends and family, and contribute something of yourself to the cosmos!

What IS Therapy, Anyway? Part 2

Once clients have addressed their original, presenting issues, it’s time to move into deeper waters. Inevitably, new challenges will continue to emerge and it’s important to explore the unconscious processes that are fueling self-defeating thoughts and behaviors—and causing depression and anxiety. Although few clients pursue long-term analysis anymore, therapists generally spend some valuable time exploring early attachment and family-of-origin issues for patterns and clues to their clients’ psyches.

An example: a female client who had a domineering mother marries a domineering man and in addition, takes a one-down position in most of her other relationships. She can’t say “no” and is a people-pleaser. She accommodates herself into oblivion and becomes depressed. A therapist can help her see that she is playing the same role she had in her original family. As a child, she had no choice; to stand up to her mother was not safe. But now, as an adult, she must stand up and develop a voice in her own life if she is to thrive. The therapist re-frames her depression as a powerful wake-up call, an opportunity to take charge of her life. Human beings unconsciously choose the familiar, no matter how negative, until they can gain the insight to act on their own behalf.

Then there is the question of meaning. This is twofold: the meaning clients assign to different experiences/situations; and life meaning—what makes their lives meaningful. When clients confront obstacles or have any kind of experience, they automatically assign a meaning to them—usually, positive or negative. But such “meaning” is subjective and doesn’t exactly represent reality. In the same way, the life stories clients tell therapists emerge through such a subjective—and often distorted—lens. The therapist’s job is to challenge the meaning they are assigning to particular experiences (especially if it’s causing a roadblock), and eventually help clients deconstruct their life narratives and re-create them in a more objective and empowering manner. Clients who were abused, neglected or bullied as children, for example, can begin to heal once they’re able to perceive themselves no longer as victims but instead as resilient human beings—survivors.

Finally, regarding life meaning and purpose, there is the ultimate existential question: Why are we here? Do clients have a passion that gives them a compelling reason to live? This is not about hobbies like hiking or gardening—though these pursuits can certainly promote well-being. To paraphrase the late Viktor Frankl from his concentration camp memoir, Man’s Search for Meaning, man comes to the meaning of his life in three ways: through good deeds or meaningful work, through love and relationship and especially through what he calls “transcendence”—transcending oneself to help others. He said that he and others survived the camps by reaching beyond their own misery to lift up their fellow prisoners. That is to say, they had a purpose greater than themselves.

Contemporary spiritual leader Rick Warren says virtually the same thing. In his best-selling book, The Purpose-Driven Life, his first line embodies this philosophy:

“It’s not about you.”

When I work with clients, we generally confront this spiritual material once we have been working together for a while`. And admittedly, life meaning and purpose become more critical for clients as they move into middle age and beyond. As Jungian psychotherapist James Hollis says in his book, Finding Meaning in the Second Half of Life, humans spend the first half of their lives growing up and setting up the structure of their lives—pursuing an education, establishing a career, building a family. People often don’t have the bandwidth for deeper meaning and purpose—beyond family and career—until they have settled into their lives and perhaps even launched their children. Obviously, therapists have to meet clients where they are developmentally. When individuals are in the second half of their lives, says Hollis, they are more contemplative and hence more receptive to the “soul knocking on the door.” When the same angst keeps coming up again and again, they must eventually answer the summons if they are to move forward.

Although some fortunate people have meaning and purpose built into their jobs (think: doctors, nurses, teachers, writers, artists, etc.), many others must find a purpose outside their 9-5s. Obviously, marriage and parenthood—families—serve much of that need for many. But when human beings are older and back to themselves, so to speak, they must find or create meaning and purpose all over again. Changing careers, retiring and pursuing a long-forgotten talent, traveling and volunteering are all possible avenues. A hero in this vein is former President Jimmy Carter, a brain cancer survivor at 93 who is still volunteering, building houses for Habitat for Humanity. He is the very definition of Frankl’s “transcendence of self.”

Again, regardless of life stage, therapy can empower people to stop running maniacally on the psychic hamster-wheel. Instead of recycling the same thoughts and behaviors, committing to this deeper work can liberate clients to jump off the wheel and out of the cage.

What IS Therapy, Anyway? Part 1

What goes on in a therapist’s office is a mystery to many who have never pursued psychotherapy. First-timers are often nervous and uncertain, not knowing what to expect. A common misconception is that therapy is some sort of cathartic, secular confessional, or that the therapist will magically “fix” the client—cure depression, anxiety, grief, social isolation, relationship and career difficulties.

Instead, a therapy session is more like a compassionate conversation. Regardless of the techniques or modality utilized, therapists work first to establish trust and rapport as a vehicle for getting to know the client through active listening. Since clients are the experts on themselves, the therapist’s role is to support clients in taking an honest look at their lives and the thoughts, feelings or issues that are getting in the way. The therapist is trying to determine how accurately clients perceive themselves and their world, how they operate in their lives—and where they might be getting stuck. Shame is often a roadblock and can become a powerful defense. Since people generally don’t see themselves as others see them, the therapist functions as a kind of gentle mirror for the client—a reality check. Over time, the therapeutic relationship itself can become a microcosm of how the client behaves with others in the larger world.

Some common goals I work toward with clients are pretty straightforward:
-becoming more honest with themselves and hence more self-aware
-getting to the root of their shame
-embracing their “true” or core selves
-reframing depression and anxiety as “wake-up calls” to address their emotional/spiritual immune system
-gaining insight into the various and often dysfunctional roles they play (and how they relate to the roles they played in their original families)
-challenging themselves in order to grow
-becoming more reciprocal in relationships
-developing or deepening empathy for others (learning to see things from others’ perspectives)

-learning to establish appropriate boundaries

-developing a clear voice in their own lives without bulldozing others
-practicing self-compassion

Christopher Peterson, author of A Primer in Positive Psychology, outlines similar tasks in regards to psychological health:

“-Acceptance of self
-Accurate perception of reality
-Autonomy (freedom from social pressure)
-Environmental mastery
-Growth, development, becoming
-Integration of personality”

It is important to note that addressing the aforementioned tasks is virtually impossible in isolation. Neuroscience bears out that it is the relationship between therapist and client that is especially critical in therapy—more important, according to several studies, than the modality used. Since our brains are “wired to connect,” having a trained and empathetic ear—a trusting relationship—is critical in clients’ motivation to make positive changes. This harkens back to Attachment Theory, which holds that our earliest attachments with parents or other loving caregivers provides the template for later relationships. For clients who have experienced compromised attachment, the therapeutic experience can serve as a sort of healing “re-parenting” or corrective emotional experience. To wit, human beings thrive in connection with others.

As clients gradually begin to trust, they can let down their guard and begin to shoulder personal responsibility for their own thoughts and actions. Blaming the world and others for their unhappiness or failures is as unproductive and misguided as taking on what is not theirs to bear. Therapists can help clients identify their strengths as well as self-defeating patterns, focusing of what they can control—themselves. And they can teach clients to forgive themselves and practice critical self-compassion.

Once they feel deeply seen and heard, once their shame has been addressed, clients can begin to heal themselves. The therapist essentially joins them on the journey and guides them in accessing their own, innate resilience.