What is Considered Progress?

Today’s post is building on a previous blog post about feeling stuck in therapy, so if you hadn't read it yet click here. The topic of the previous post was a discussion on the frustration clients may feel that the work in therapy isn't creating significant change for the client in their life. A concept I will introduce to clients is that progress often occurs in the process of therapy, not the product.   Ideally we’d love to repair those hurtful relationships, nail the interview for the dream job, obliterate depressive/anxious symptoms, and have the difficult conversations, among many other desires; but there are so many other variables around those situations that we have no control over that can get in the way of the preferred outcomes….which can leave us feeling helpless and hopeless. That’s when we are best served by focusing on our process in therapy as opposed to the outcomes alone.

Let me give an example to demonstrate what is meant by this.  Sometimes a client and I will determine that journaling could be of use in the therapy process. Often folks are concerned about the content of their journal entries not being what it “should” be in order to be helpful. In my own journaling I've given myself permission to create entries that are simple bullet points, one word, or nonsensical run on sentences -whatever it is that is needed that day.  This has made the process of journaling a lot more accessible and a lot less intimidating.   If I was worried about the content or the product of my journaling, this would probably be a barrier to my engagement in the intervention.  But the act of externally expressing and processing thoughts and feelings is what is actually helpful about journaling not the actual contents on the page.  I typically discourage clients from going back and reading journal entries unless we can decide together some sort of therapeutic benefit of that

Another example would be working with somebody who's afraid of confrontation preparing to have a difficult conversation with somebody.  Identifying the conversation needs to happen, conceptualizing the conversation, and role-playing it in their mind or in therapy is all progress even if the client never gets to the point where they have that difficult conversation.

Stepping away from black or white thinking when it comes to evaluation of progress can create many more opportunities for success and allows the process to feel much for flexible to the individual.

I'd invite you to think of times in your life where you've been hard on yourself because the product of your efforts didn't turn out the way that you originally envisioned. Go back and think about the process you engaged in first- are there spaces and places where you can identify progress being made even though the outcome didn't align with your original vision?  

I hope this way of thinking about your efforts both in and outside of the therapy room can help you extend yourself some compassion and grace as you continue to face different hurdles in life.   If you think you could benefit from additional therapeutic support click here to contact us!

Disordered Beliefs About Food and Your Body: When to Seek Help

By Caitlin Hopkins, LMSW

As a therapist for the women, I have noticed one unfortunate, heart-wrenching truth: no matter what she originally came to therapy for, somewhere woven within her story will be a disordered eating thought, experience or belief.

These false beliefs, (such as that small bodies are better bodies) are rooted in misogyny, diet culture and unrealistic beauty standards. They are so engrained in society that many times at first glance, clients don’t even realize their harm. A few examples of normalized disordered thoughts and phrases that perpetuate this harmful “thin ideal”:

• “Sweating for the wedding.”

We do not need to make our bodies smaller to be worthy of marrying, nor do we need to lose weight to fit into a dress. Dresses are made to fit our bodies, as they are, not the other way around.

• Postpartum women “getting their body back.”

You just created life. You are magic. You are never going to be the person you were before having a child, and neither is your beautiful body. Accept her. Celebrate her.

• Restricting or excessively exercising before holiday meals.

Food does not need to be earned. This transactional practice of “now that I’ve burned the calories, I can have the meal” is a harmful, slippery slope, and one to be very mindful of.

These beliefs – especially when coupled with extreme stress, depression, and/or anxiety – have the potential to manifest in more dangerous behaviors and an eating disorder diagnosis.

If these messages are so prevalent in society, what is the difference between someone who has fallen victim to diet culture beliefs about bodies, and someone who has an eating disorder? When should they seek professional help?

The major distinction here is the amount of space these thoughts take up in your mind, and if they result in drastic behaviors to change your body. It is time to seek professional help if your daily quality of life is impacted. For example, if you are obsessing over the next meal, feel anxious about social events that focus on food, lie about or hide your eating habits from others, repeatedly check your body in the mirror, weigh yourself over and over again throughout the day, or if you are engaging in any behaviors that feel unsafe or extreme (restricting, binging, purging, excessive exercise).

Ultimately, whether you are someone who has an eating disorder or someone whose body image has been negatively impacted by these unrealistic societal beauty standards, your relationship with food and your body could benefit from some healing. We all deserve to enjoy food, celebrate our bodies for all they can do and accept the skin we’re in: stretch marks and all.

Feeling Stuck in Therapy

When working with clients it's not uncommon for them to feel frustrated that their work in therapy isn't moving the needle in their life in a way that feels significant.  This is especially true for those who are really invested and active in the therapy process; coming prepared to session and doing the work outside of our time.  When a client brings this frustration up in session they're usually met with this common response from me asking “And where did you learn that was going to happen?” This is typically met with the knowing eye roll or smirk from the client because they know what’s coming next.  

I think some of the hardest work that's done in therapy is in the art of letting go: letting go of the idea that you are supposed to feel a certain way, letting go of knowing what the outcomes are going to be AND letting go of trying to control those outcomes.   Oftentimes the work that one does in therapy isn't necessarily to change their circumstances (although that might be ideal) it's to help them weather their undesired circumstances better.  So maybe while the work that you're currently doing doesn't feel like it's making that big of a difference you might just be in worse shape without it. The eye roll and smirk from clients is typically because they have already done with work to recognize and accept that life is hard and usually after one hardship ends there's another one not too far behind it and they’ve discovered that what therapy is about is having a space to help navigate the thoughts and feelings that come up during these hardships not remove them. Although as a therapist I’d love to be able to help client alter or remove sources of pain, it’s typically not possible.  

This brings up another topic that I discuss with clients which is that sometimes the progress is in the process not the product; a concept I'll discuss in my next blog. To start your therapy journey connect with us on our contact page.  

On Acceptance...

For the longest time, I practiced therapy utilizing primarily a Cognitive Behavioral Therapy (CBT) model.  Widely respected, utilized and researched the structural nature of this model really resonated with my “Type A” personality.  For those unfamiliar, a very short explanation of CBT is to assist clients in identifying maladaptive thought patterns or “cognitive distortions”, train the client how to reframe these distortions, engage in desired behavioral changes and a shift in overall mood and functioning will occur.  Easy, right? 

Over the years using this model, I’ve noticed a pattern with many of my clients, especially those with anxiety as their primary clinical issue.  While reframing distortions can take clients to a certain point in managing their distressing thoughts and feelings, for many it just wasn’t enough to really contribute to a satisfying shift in overall functioning.  The residual thoughts and feelings still created a barrier between the client and the rich meaningful life they desired.

Enter: Acceptance and Commitment Therapy. 

I was introduced to the Acceptance and Commitment Therapy or ACT (spoken like the word “act”) model a few years ago in a consultation group of therapists I belonged to where we talked about cases and consulted on challenges we faced in our roles as therapists.  My colleagues shared how using this model really changed the game for a lot of their clients.  I did a little research, and signed up for a training on the approach.   Slowly after the training I started implementing elements of the model into my practice and I watched as the lightbulb went off for many of my clients. 

Contrary to CBT, rather than resisting and trying to change one’s thoughts and feelings ACT encourages clients to radically accept their existence.  What changes is a person’s response to them.  Rather than trying to talk yourself out of your anxious thoughts, you instead “unhook” yourself from their grasp and choose to coexist with them.  Kind of like the music that is playing at the grocery store while you shop, these thoughts fade into the background and become white noise.  They are still there, they still exist, but they no longer dictate what direction you go.  Instead, a client identifies and engages in “committed actions” that will move them along their journey toward what they want, desire, and value in their life in the midst of these thoughts and emotions. 

For a lot of people the idea of acceptance feels like giving up.  And in a way it is.  It’s giving up a fight with something bigger than ourselves.  Something we may not have the control over we desire.  Awhile back I was going through a tough spot in my own life and I heard something on the radio (I said it was awhile back!) that literally stopped my in my tracks.  I can’t remember what program I was listening to, but the guest speaker said something I’ve never forgotten-  “Acceptance does not equal approval”.  This really shifted things for me at the time and I’ve repeatedly shared it over the years with my clients in different contexts.  When we accept something it doesn’t have to mean we have to be happy or ok with it.  It simply means we choose to stop fighting a battle we aren’t able to win.  And when we do that we can redirect that energy into pursuing the things we find meaningful, the things we value and that will bring richness to our lives. 

One of the hallmarks of ACT is the pursuit of values which I’ve referenced in this post and will discuss in more detail in a future blog, but until then if you are struggling in finding away to identify and pursue the things you value because of unhelpful thoughts, feelings, disfunction in your relationships or distress at home or work, please don’t hesitate to reach out to see if working with one of our therapists would be a good fit for you!

Let It Go!

My last blog post was all about the utility of worry, and how sometimes we can get “stuck” hanging on to these worries. This post is going to be all about learning to let go of unpleasant thoughts and emotions like worry and the steps to get you there.

Step 1 Feel It

The first step in letting go of worry is to first connect with your feelings. We are often moving through life at such breakneck speeds that we are unable to recognize how we are feeling until it has come to a head and and we are ready to either explode or implode. Either way, it’s no good. So to hit step one, it’s best to try to slow down and be mindful of your emotions.

Step 2 Name It

Once you recognize that you are feeling something it’s important to know what exactly you are feeling. Some feelings like anger, frustration, impatience are actually masking other feelings like worry, hurt, fear and sadness. As part of Step One your challenge is to slow down and recognize your feelings, the next part is to think a little about your feelings and make sure that what is being expressed is really what the fundamental emotion is.

Step 3 Release it

This particular step can feel a little “hippy dippy” when I describe it to people, but it’s a necessary part of letting go of unpleasant emotions, like worry. This is where you make a conscious decision not to let this emotion take over. This can be done by simply taking a deep breath in and saying to yourself “By breathing in I recognize my emotion and by breathing out I release it”. Sometimes it can help to speak to yourself in the third person to lock your mind in to what you are asking it to do.

Step 4 Redirect It

The final step is to redirect your mental energy. It’s important to have an arsenal of pleasurable activities that engage your mind when you are feeling poorly and your mind is running away from you. Watching a favorite show, engaging in a hobby, doing something artistic or creative are all ways to distract your mind from your worry. This is not simply distraction on it’s own! It’s very important to do the other steps first and not just jump to this one. Engaging the entire process is imperative to letting go as opposed to just distracting your mind from it. We know when you just distract the thoughts and feelings have a way of coming back bigger and stronger.

Hopefully you find this information of use to you in letting go of unpleasant and stuck emotions. If you find you are still experiencing difficulty, you might find it useful to speak with a professional counselor or therapist to move you through your stuck points. Feel free to reach out on my contact page for more information.

Surviving Postpartum with Twins

The first in my guest blog series is all about the postpartum experience with twins written by therapist and twin mom, Lindsey Lowrance. Enjoy!

It’s Twins! (Gulp, Faint, Whaa?) Here’s What You Need to Know

What’s different about having twins?

While helping twin moms go from drained and distracted to powerful and fulfilled, I’ve learned that there are some things that are very different for parents of twins and multiples. I’m a twin mom myself and can also speak from personal experience. The question on everyone’s mind when this comes up is ‘what’s the difference?’ Isn’t it just an extra baby in the mix?

Actually, there’s a lot more to it than that. When one parent is on their own with both babies (whether this is running an errand or staying at home while the other parent works), they are outnumbered and often overwhelmed. Many moms of twins stress that they can’t do all the bonding activities that moms of single babies do, partially because of logistics and partially because there is so much extra work and attention that needs to be divided. Can you imagine taking two babies to a Mommy and Me class?

Logistics are one of the hardest obstacles new parents of twins have to conquer. Here are some examples: how will I get both babies in and out of the car at the same time? How will I feed both babies at the same time (or do I feed them one at a time while the second one screams impatiently and this doubles the time it takes me at each feeding)? What if I’m out in public and they both are crying- how can I help them both at the same time without an extra set of hands? Will people think I’m a bad parent because I don’t have time to shower or get dressed for the day and my babies keep crying while I take care of one and then the other back and forth in a frenzy?

Many moms of twins can feel envious of other moms that get to peacefully hold and rock just one baby the whole time they are in public, or gaze lovingly into their baby’s eyes without having any distractions (like a twin baby needing mom’s attention). First time parents usually try hard to do everything perfectly according to their parenting plans and ideals, but with twin parents they often have to quickly throw out any ideas of perfection, timeliness or organization and learn to accept the chaos.  

Don’t get me wrong, having twins is something so special and magical in its own way. While we often hear what is hard about it, there are so many wonderful things too like twins being best friends, or having a unique bond from the get-go. I’m happy to be a part of the twin community because I get a front row seat at the cool twin life and to witness their incredible relationships. I wouldn’t change it for the world! But there certainly are differences and challenges that are worth hearing about so you know that you aren’t alone.

What’s Different About Postpartum with Twins?

  Newborns take a lot of work and it can be stressful adjusting to huge life changes like this.

Parents with newborn twins are usually in survival mode, chugging away at tasks day and night to keep those little babies fed, clean, and healthy. Many couples assume it will be miserable the first 6 months or so because they’ve been warned that the first 6 months (or year) of having twins will be SO HARD. Parents of multiples also sometimes hear that the divorce rates are higher and that raising twins/ multiples is very tough on relationships.

It doesn’t HAVE to be miserable! Yes- it’s a lot of work and so many things change, but having twins CAN be wonderful in its own right.

What many parents of twins/ multiples don’t realize is that postpartum mood disorders are actually more common given all the stress and financial strains of having more than one newborn. Postpartum depression/anxiety tends to happen in the midst of chaos and sleep deprivation that it can be hard to notice that you are not dealing with the “normal” amount of stress. Let’s face it, it’s hard to know exactly what is normal when managing two or more babies at once!

How can we tell when we are dealing with a ‘normal’ and expected amount of stress or when there is something more going on?

While pregnant, we all imagine having these wonderful, magical bonding moments with our new babies and soaking it all in. We dream happily of the beautiful connection that moms have with their new babies and all the adorable little baby toes and fingers.

What if you don’t get those magical moments with your newborns? What if it’s all hard work and you don’t feel those happy, blissful moments when the babies are here?

It turns out that postpartum mood disorders (depression, anxiety, PTSD, and OCD) are all too common in the twin world, but we don’t really talk about it. Twin parents (yes partners too) are at a much higher risk of having a mood disorder in that first year. Why is that?

When having twins or triplets, there are some extra stressors that a couple deals with that put them at higher risk of postpartum moods.

·         Financial strain (2 babies equals 2 of everything, not to mention daycare costs and hospital bills)

·         Extra hormones from pregnancy & postpartum due to physically carrying more than one baby (Yes, your body is impacted more and has an increase in hormones and blood flow than a woman carrying one baby)

·         Extra stress! (It’s not just twice as much work, it’s the lack of breaks/ rest and being out-numbered when one parent goes to work or runs errands)

·         Little to no support from family or friends (it’s hard to keep in touch when you’re run ragged on baby tasks and little sleep. Unfortunately, many don’t have family nearby and can’t afford to hire help, which leaves them really strained to do it all without help)

·         Many parents of multiples experienced infertility or complications with pregnancy, birth or breastfeeding (When there are 2 babies the pregnancy gets more complicated and is treated as high risk. Birth can feel like it’s totally out of your control when medical teams decide what’s best and take charge.)

Each of these factors increase your chance of having depression, anxiety, or other impacts on your mood.

Baby Blues: The first 4 weeks after giving birth, it is completely normal to have extreme emotions and hormonal mood swings because your body is going through major changes. Any woman going through the intensity of hormone changes in her body will have some adjustment period. It is not necessarily depression or anxiety. If it continues, then it can be helpful to check in on how you’re really doing.

Did you Know:

·         If you have ever experienced depression, anxiety or any mental health issue before pregnancy that you have a much higher chance of developing postpartum (or prenatal) mood disorders?

·         High risk pregnancies, pregnancy complications, NICU time, and problems with breastfeeding can lead to more struggles with mood?

·         Perfectionists &/or people with high expectations are more likely to suffer?

Here is a checklist of some common things to look for so that you know if your struggles cross the point of needing something more.

Checklist for Postpartum (or during pregnancy) Mood Issues:

o   Zoned out or distant

o   Irritated very easily

o   Overwhelmed most of the time

o   Not feeling connected to kids/babies, partner

o   Feel like you’re just barely surviving day to day

o   Worried about _____ most days or for long periods of time

o   Fighting with your partner more than usual

o   Yelling at your kids often

o   Feeling like a failure

o   So much guilt!

o   It’s hard to be around other people

o   Not interested in things you usually enjoy

o   Scared that something bad will happen to your babies

o   Trouble sleeping even when the babies are sleeping

Checked a couple things on the list? It may be time to talk with your doctor, OBGYN/ midwife, or call a therapist to figure out how to make things better.

You CAN feel good while surviving the chaos of newborn twins, and you CAN enjoy moments with them and feel like yourself! It’s a big adjustment Momma, and you may need some extra support. There’s nothing wrong with that.

Brought to you by twin mom & maternal mental health specialist Lindsey Lowrance at Twin Mom Power. Lindsey is passionate about helping twin moms Go from Drained & Distracted to Powerful & Fulfilled! For more information & resources on surviving & thriving the twin life go to: www.lindseycounseling.com or Email: lindsey@exploringinnerpeace.com Phone: 720-243-3993