Generalized Anxiety Disorder (GAD) is a label often given to people who worry excessively about many different things. They worry both to the point of making themselves significantly distressed and to the point where others start to get exasperated because they really don’t find the anxious person’s worries to be justified or realistic.
Why Do People Worry?
The first step in understanding the tendency to worry is to acknowledge that worrying is generally intended to be a helpful mechanism that reminds us of things to watch out for. Its purpose is to keep us from getting in trouble.
Worrying in itself is therefore not a problem. It is what makes me move my car from an area with unclear signage to avoid getting a parking ticket, and what makes me arrive 30 minutes early for a job interview just in case there would be an unexpected accident that would slow me down on my way. These kinds of anticipations of bad things happening generally serve me well. They help me plan for eventualities that could harm me and make me feel more in control of my life circumstances.
When Do We Worry Too Much?
In the life of someone with generalized anxiety disorder, however, worrying no longer serves it’s intended function to help us adapt well to genuine risks and challenges in our environment.
Here the worries have a number of characteristics that make them more burdensome than helpful. This is because the nature of the worries frequently includes a number of different exaggerations that distort the true risks involved.
These exaggerations fall into a number of different categories, which it will be helpful to understand so we know what we are dealing with…
Here they are one by one…:
Frequent Worries of Highly Anxious People:
“I take too much responsibility for others instead of setting healthy boundaries:”
This kind of worry places excessive blame on myself if something were to happen to someone else. For example: “If my friend feels alone or depressed, it is probably because I am not doing nearly enough to hang out with them” or “if my boss gets annoyed or frustrated with me, it is probably because I am too lazy or unintelligent, or because I am a bad employee”. Not only does this kind of worry tend to turn to self-blame and excessive guilt, it also makes me feel that I constantly have to prove myself to others in order to be a good friend, good employee, good spouse and so on. It is therefore not unusual for people with generalized anxiety to overextend themselves, to take too much onto their plates, and to leave very little room for themselves and their own needs.
“I look to others for answers rather than trusting my own intuition:”
People with generalized anxiety often have a fundamental mistrust of their own decision-making. They fear that they would be unable to cope, or would be responsible for other people’s suffering, if they were to make a wrong decision. For this reason, people with generalized anxiety will often seek expert advice rather than consult with their own intuition, or they will defer to others about which restaurant to go to instead of feeling within what they are really in the mood for. This other-oriented living is just another way that the person with generalized anxiety silences their own voice and lives in hiding from their own needs, rights, wishes, and feelings.
“I externalize my anxiety rather than looking for the cause within:”
People with generalized anxiety live in constant anticipation of bad things happening around them that they think they would have prevented if only they were proactive enough or paid enough attention. Their constant attention to dangers in the environment conceals the fact that the real danger in generalized anxiety is often a danger from within. Clinical wisdom tells us that the fears that underlie my worries in GAD are really fears related to the eruption of emotions such as sadness, anger, or insecurity that I feel within myself and that I don’t think I can cope with. People with generalized anxiety often have an unconscious fear of disintegration, helplessness, and emotional overwhelm, which makes them live in fear of their own emotions and makes them want focus their attention outward instead of inward. Instead of dealing with their fears of their own emotions, they instead worry about physical symptoms in their body which they mistake for possible illnesses, or about other people for whom they feel responsible, or about eventualities in the future they can plan for or try to control.
“I blame myself rather than feel angry at others:”
People with generalized anxiety often have a hard time standing up for themselves, saying “no” to others, or feeling justified for having their feelings. Anger, which is the emotion that alerts us to boundary violations, injustice, and unfair treatment often evokes anxiety or feelings of guilt in people with generalized anxiety. As a result, the anger often gets converted into excessive people-pleasing and excessive self-blame. If someone gets mad at me, I internalize their anger and use it to beat myself up for my wrong-doings, or if someone offers a negative opinion about something I did, I take it to mean that I have inner defects or short-comings that I need to make up for. The lack of comfort with anger makes me invalidate my own perspective or right to self-define, and leaves me vulnerable and exposed to criticism from others.
How to Overcome Debilitating Anxiety:
The first step in overcoming generalized anxiety and excessive worry is to make the different kinds of excessive, unfair, or unrealistic patterns of self-protection which I have described above problematic to the anxious worrier. The person with generalized anxiety has to be helped to disentangle themselves from the part of them that worries or scares them. They have to realize that worrying and feeling anxious is something they do to themselves rather than who they are.
This differentiation of themselves from their worries is best facilitated by a therapist who can help them name both the ways in which they worry themselves and what it feels like to be on the receiving end of these worries. The outcome of this kind of differentiation is that they can begin to understand the needs and fears of the “worrier”, as well as the feelings of helplessness, inadequacy, and plight of the part of them that can never get a break from the “worrier”.
Helping the Worrier Turn Attention Inward:
Instead of the therapist simply joining with the more dominant worrier voice and helping this part of the person find the reassurance that it constantly wants but can never find, the therapist instead helps both parts of the person address the underlying emotional needs that never get tended to as long as the worrier simply pursues its agenda of finding reassurance outside of the anxious self.
The solution to the worrier’s problems is not to be found in getting reassurance or advice from the therapist, or finding ways to be better, stronger, smarter, more accomplished, more likable, or more in control. These are the pseudo-solutions the worrier tries to pursue to avoid addressing the source of their own vulnerability, and are ultimately very hurtful and damaging to the part of them that has to live underneath the weight of these responsibilities.
The Real Cause of Generalized Anxiety:
Once the person with generalized anxiety stops looking for solutions in never-ending self-improvement or never ending pursuit of more control, he or she is finally able to address the real issues at the heart of their worries. They can now gradually come to face the earlier life experiences that have made them feel too frail, too vulnerable, too unsupported, or too overwhelmed.
To do so, the person with generalized anxiety needs to be helped to turn their attention inward toward the pain they have avoided confronting, so they can become more comfortable with their own emotions and more grounded within themselves.
One reason that this has not been possible so far is that the person with generalized anxiety has learned to dismiss those feelings inside of them that were to uncomfortable or distressing to others around them .
The worrier came to be dismissive of their own feelings and needs because others were not there for them the way they should have been or because others could not handle or tolerate their emotions.
It is this original or ongoing rupture in compassionate understanding from others that often needs to be addressed in therapy so the person with generalized anxiety no longer needs to shut themselves down or turn their gaze outward.
The solution to generalized anxiety is therefore not to increase the effort to control situations and become ever more perfect. It is to become ever more comfortable with acknowledging your own vulnerabilities and learning to find ways to soothe and comfort the part of you that did not feel safe, supported, or reassured when growing up.
Human beings are constantly faced with making the choice between two paths: One path that keeps them in the safe and comfortable straits of what they know, and another that entices with a different way of being, less restricted and more promising.
Which way should I go? Should I stay in my comfort zone or venture down the path of novelty?
This question becomes heightened for every person who chooses to come to therapy.
The Price We Pay for Staying Safe:
The decision to see a therapist is by definition the decision to heed the murmur from deep inside that begs of the person to leave the safety of the familiar and take a turn towards something new.
Why does the person want to do this?
Because the familiar, for all its safety, is often also a great source of suffering.
A few examples will illustrate this:
I live most of the time in my head where I can plan and feel in control of my life, but this is also my curse, for I cannot really surrender to my feelings and cannot really feel much passion or excitement in my life.
I live most of my life in the pursuit of achievements so I can finally become popular or accepted by others, but this relentless striving is also the source of my sense of being a failure and not being good enough or lovable just the way I am.
I bottle up my emotions and consider sadness and the need for others a sign of weakness, but this also keeps me isolated and alone and causes anxiety whenever my sadness is never far around the corner.
In these examples, the Faustian bargain to preserve my integrity, my self-esteem, my pride, or my security, came at a price and this price is what brings me to therapy:
I am not happy, I am not at peace with myself, I worry about unknown threats from the inside, or look around me and find that my life looks more restricted than that of my friends or my neighbor.
I am growing tired of the price of safety. My desire for growth and for change now has the upper hand.
Why Do We Often Choose Misery over Growth?
However, as I enter the therapy room, my sense of safety comforts me where novelty frightens. I feel new things, but these feelings are strange and alert me of a danger. My therapist gently asks me to get out of my head and into my body where feelings live, and I all of a sudden feel out of control, unsure of my direction, and vulnerable to harm.
I start to think, maybe my Faustian bargain was not so bad after all. The path of novelty is filled with dragons. Better the devil I know!
It is tempting at this moment to retreat and to make peace with a lesser life.
As the Danish existentialist philosopher Soeren Kierkegaard rightly says in one of his essays:
“In addition to my other numerous acquaintances, I have one more intimate confidant. My depression is the most faithful mistress I have known — no wonder, then, that I return the love”
Kierkegaard’s depression, like my anxiety, or your deadness have been the bedfellows of our lives. For all the misery they bring to us, they are after all compromises intended to ward off something worse, and protect us from the dangers of a life without them.
Well, it is more logical than one would think.
Why Are We Reluctant to Give Up Misery?
Every person who comes to therapy has an innate need for self-preservation and an innate need for growth.
The need for self-preservation got activated early on in life to help us deal with unpleasant experiences and ruptures in our relationships with others.
We went into our head, numbed ourselves to sadness, or befriended our self-critical voice, because we needed to do so to stay safe and minimize the risk of harm.
However, now as adults, what we could not deal with as children or as adolescents, is no longer the same kind of existential threat to us, and yet we continue on with the same old coping that helped us survive when we knew no better.
Now in our therapy when our therapist wants us to venture outside our customary coping to see if the dragons are still there, we instinctively want to coil back and stay inside the cardboard box we have constructed to stay safe, but which has also become our prison.
We all Resist Change at Some Level:
In therapy, we have a word for this desire to sacrifice our growth for a life of a certain kind of misery. We call it resistance.
Resistance is not a conscious decision. It is the decision our organismic need for safety makes for us, even if we consciously complain of the very life patterns we secretly gravitate towards.
Resistance keeps us away from the real pain, the real fears, and the real sacrifices we have made, and thereby prevents us from having new experiences that would help us resolve old wounds and make us leave therapy transformed.
We all Want Change at Some Level:
Luckily, we have another voice inside, another striving or drive that will not be silenced and will continue to remind us that we are limiting ourselves, until we aren’t anymore.
Psychologist Diana Fosha has named it our transformance striving, and it is just as powerful of a contender as our resistance. If we don’t heed it, it will nag us like a kind of existential guilt, the kind that will make us filled with regrets about what we could have done or should have done when we look back at our life in old age.
How Therapists Help People Grow:
The role of the therapist is to appease the resistance while allowing more room for the transformance.
The therapist does so by providing enough safety and comfort for the person to attempt something new, and helps the person reflect on and experience the benefits of their little excursions outside their comfort zone.
They align with the transformance striving which gradually becomes loud enough to defeat the resistance.
When the resistance is no longer keeping the person stuck on the same fearful path that have limited their lives for fear that they could not cope with the alternative, the person realizes that they have more resources and capabilities than they previously thought.
They are now free to choose the path of growth over the path of safety at the cross roads of their lives.
I always liked the saying “The illness is the cure”. Why? Because in the area of mental health, it alerts us to something profoundly insightful about the nature of the psychological and emotional problems most people struggle with.
Whether we feel depressed, have panic attacks, or generally feel weak, bad, or inadequate, these kinds of problematic states and ways of suffering are rarely ever simply problems to be removed or eradicated. They are NOT the illness, but like a fever or a cough, a symptom that alerts us to something about our life or our approach to life that is off-kilter, wrong, or in need of change.
Like the red lamps on the dashboard of a car, they alert us to the problem, but are not themselves the problem.
The Fallacy of Treating the Symptom as the Cause:
There is a real fallacy here that many people fall into if they do not realize this nature of their psychological distress.
If they simply think of their anxiety or their depression as the problem, then they might try to medicate the symptom to the exclusion of finding out why the symptom is really there.
In some sense this approach would be tantamount to attempting to solve a car issue by smashing the red light on the dashboard.
However, when you realize that the psyche uses the symptom of depression or anxiety to alert us to the fact that it is ill or that something in our life needs to change, our symptom becomes more of a friend than a foe. It now serves as a calling to resolve an issue which we may have been avoiding or which has stumped us in some way.
As in the saying “the illness is the cure” it serves merely as the first step toward the cure, and as such it is in fact the first step toward a transformation and reorganization that needs to occur for balance and health to be restored.
Way too often, we short-circuit this natural healing process because we get frightened by the calling and can’t see the road ahead. We mistake the symptom for the cause, and the burgeoning cure for the illness itself.
Discovering the Truth of Our Symptoms:
There is a depth of understanding that has gotten lost in our current search for quick fixes and immediate happiness, but was always there in the minds of the founders of the craft we now call psychotherapy.
A psychiatrist like Carl Jung, for example, beautifully wrote about heeding our symptoms as a calling:
“Depression”, he said, “is like a woman in black. If she turns up, don’t shoo her away. Invite her in, offer her a seat, treat her like a guest and listen to what she wants to say.”
Even poets have alerted us to the fact that our distress is merely a signpost toward making necessary changes. As Rainer Marie Rilke writes:
“Why do you want to shut out of your life any uneasiness, any misery, any depression, since after all you don’t know what work these conditions are doing inside you? … If there is anything unhealthy in your reactions, just bear in mind that sickness is the means by which an organism frees itself from what is alien; so one must simply help it to be sick, to have its whole sickness and to break out with it, since that is the way it gets better.”
Sigmund Freud, too, reminded us of the danger of not listening to our symptoms, for as he rightly warns us:
“Unexpressed emotions will never die. They are buried alive and will come forth later in uglier ways”
The Calling of Symptoms is to “Know Thyself”:
So much gets lost when we don’t heed the advice to listen to our symptoms and pursue them as the first step toward a cure.
Depression, anxiety, badness, and upset, cures itself once its truth is understood and its emotional conflicts disentangled.
The calling of mental illness is to “know thyself”.
The calling is not for a dimming of your awareness through medication, quick fixes, or a rush to premature action, but for an expansion of your consciousness, so you can reap the benefits of your psyche’s own wisdom, and find out more about what is meaningful and central to you at your core.
Illness is not a destination, but a way-station, and those who dare to unlock its message will be amply rewarded and transformed in the process.
About me: I am Rune Moelbak, Ph.D. psychologist in Houston, TX. I help people work through their symptoms of anxiety and depression to achieve a transformation to a better, lighter, and more centered self.Visit my website for more information.
Recently I came across an excellent video on some of the common misperceptions many people have about psychotherapy that might stop them from ever seeing a therapist.
As the short video below from my colleagues at the The School of Life in London illustrates, these myths include:
Psychotherapy is only for people who are strange, abnormal, or deficient in some way
Psychotherapy is only for people who don’t know how to solve their own problems
Psychotherapy is nothing different than simply talking to a good friend
Psychotherapy is not affordable and is not worth the cost
In this article I will tell you why these four statements are misconceptions, and why you should not be so quick to dismiss the benefits of meeting with a well-trained professional psychotherapist.
But before we get there, first watch the video:
As you can see from the video, psychotherapy is frequently not what people think it is…
Let’s examine some of the myths about therapy a little further:
4 Myths that Might Stop You from Seeing a Psychotherapist:
Misconception #1: Psychotherapy is for People Who are Abnormal
One of the most liberating ideas I was presented with as a student of psychotherapy was the idea that all humans struggle. As the famous psychodynamic therapist Nancy McWilliams has pointed out, the question to ask yourself and others is not: Are you crazy? But rather: How crazy are you? and crazy in what way?
This is in many ways the basic premise of psychodynamic psychotherapy: We all have our little neuroses, traits, or peculiarities that get in the way of living the life we wish we could live. We are all a little crazy and a little irrational at times. We all have some fears that other’s don’t. And we all get into situations that overwhelm us, make us fall short, or make us doubt ourselves.
Maybe we find ourselves dating the same type of ill-suited partner over and over or making the same relationship mistakes.
Or perhaps we find it hard to express our needs to anybody in authority, which creates problems at work, or make us sabotage our own success by turning assignments in late.
Whatever the situation may be, we all have something we struggle with that works against our better interest.
The only thing that distinguishes a person who seeks out psychotherapy from someone who doesn’t is therefore their willingness and courage to face the inherent struggles of their human existence.
The distinction is therefore not between someone normal and someone abnormal, but between someone who chooses to hide their abnormality behind the semblance of normality, and someone who recognizes that abnormality is normal and therefore gives themselves permission face their life as it is, not as they wish it to be.
Misconception #2: I Should Be Able to Solve My Own Problems
Okay, so now that you have recognized that all humans struggle, you no longer need to distort your own reality to try to fit in to some illusory idea of what is normal.
However, you may still feel a little ill at ease about asking somebody else to help you with your problems.
Why? Because our culture in general often ascribes strength to the ability to fix-it-yourself.
Many people feel like it is a sign of weakness to not be able to handle whatever issues they are facing on their own. Instead of going to see a psychotherapist many people will therefore instead try out self-help books, or resort to self-made coping mechanisms such as alcohol and drugs, avoidance techniques, or putting on a forced smile.
However, a psychotherapist can accomplish something with you that it would be difficult if not impossible to accomplish on your own.
In fact a psychotherapist will not just listen and try to offer up new suggestions or solutions. Instead they will help you discover new thoughts and feelings that you have not been paying attention to or may have pushed out of your awareness. In this way they will help carry you beyond your own conscious knowledge of your problems, and will help you see and experience yourself in a new way.
In many ways, psychotherapy is really a process of standing back from your problems to see the bigger picture. Rather than offering solutions to the problems you think you have, psychotherapy helps you view your problems in a new way, so that the solutions you think you wanted, may not actually be the one’s you want.
Psychotherapy is therefore not a linear process of solving a problem, but a transformation of the very way to you experience yourself and your problems. It changes the context within which you view yourself, so that your very desires, needs, and wants may change.
The idea that you should be able to solve your own problems does not apply when it comes to matters of your psychological existence. The solution here is not one you can arrive at simply by applying logic to a known problem. Instead, it involves a dialogue with someone who can listen in a different way based on parallel thinking, association, and the logic of the irrational, and can help you expand your awareness of things you didn’t know before.
Misconception #3: I Might as Well Just Talk to a Friend
A friend and a psychotherapist are two very different characters.
We all can benefit from talking to friends. However, as many people often instinctively know, friends frequently don’t really offer the kind of listening and attentiveness that helps us feel comfortable opening up about our deepest fears and most embarrassing quirks.
This is why one of the first training goals for new students of psychotherapy is to unlearn their instinctive ways of responding as a friend.
Friends often do well-intentioned things that psychotherapists have learned are not really helpful.
As friends we often offer encouragement to help others not feel so bad about things. We try to cheer them up by telling them that things will be fine, or giving them reasons why they they should not feel sad, or guilty, or what have you. However, this inadvertently sends the message to the other person that we can’t tolerate or don’t want to hear about their pain, and that their pain is “irrational” or silly.
As friends we also often offer advice based on our own experience of what has worked for us, but such advise is often premature and ill suited for a person with other values and inclinations than our own. If you are honest with yourself, how often do you really find other people’s advice helpful? Most of the time, only when a part of you was already kind of thinking about doing the thing you friend has suggested. More often, however, advice simply feels invalidating and infantilizing. If our problems were so simple that we could simply solve them by following some piece of advice, we could probably have thought of the solution on our own.
An excellent video that illustrates why advice and encouragement is really not that helpful is Brene Brown‘s video on the difference between sympathy and empathy:
Finally as the video from The School of Life illustrated, friends most likely don’t have the deep understanding psychotherapists have about the complexities of human nature and the “normality of abnormality”. Friends therefore often have more limited views of what is acceptable, normal, and good and less tolerance for what is outside the cultural norm in our society or our immediate friendship groups. It therefore often does not feel that safe to admit to feelings or thoughts that may not be in line with what we think others deem to be acceptable or normal.
A psychotherapist on the contrary has a discipline to how they listen, how they respond, and how they make sense of what we say. They don’t make premature conclusions, don’t offer premature advice, and don’t shut down explorations of the aberrant or what lies outside of cultural standards of good and bad. This means they can meet us where we are, tolerate a wider range of our emotions, and help us expand our own knowledge and awareness of what we really think, feel, and want, even when we can’t quite accept these things about ourselves.
Misconception #4: Psychotherapy is Too Expensive
It is true that psychotherapy can often be quite costly. This is both because good psychotherapists need a lot of training, and because psychotherapy by nature is a very time and labor intensive process.
When it comes time to consider whether therapy is really worth the expense, it is often helpful to consider the value you place on living a life of greater self-knowledge and awareness. For some people this kind of life is not really a priority, and for those psychotherapy will almost always feel too expensive.
If, on the other hand, you value living a more conscious life, you will feel less hesitant to see it as a worthwhile investment and will almost always be able to find room within your budget to see a psychotherapist.
At the end of the day it is often not the price of psychotherapy that is prohibitive, but the value you place on it.
Some people will easily spend thousands of dollars on a vacation, or will not hesitate to get Lasik surgery for their eyes, or Invisalign for their teeth, but will not want to spend the same kind of money on their mental and psychological well-being.
However, as the video from the School of Life makes it clear, life is not a skill we instinctively master, but a skill we have to learn. This in my book, makes psychotherapy an essential ingredient of any person’s quest to live a more fulfilling life.
About me: I am Rune Moelbak, Ph.D., psychologist and psychodynamic psychotherapist in Houston, Texas. I help people get to the root of the problems that are causing them distress so they can live more fulfilling lives.
The title of my blog post this week contains one of the essential insights of my work as a psychologist.
Too many people spend their lives leaving places they have never actually arrived at.
A person who had a traumatic childhood might say they would rather just forget about the past and move on, which is their way of leaving without first arriving.
Another person might spend their entire life in a search for meaning on the mountain tops of Nepal or in the pursuits of promotions or recognition at work, which is their way of not addressing the source of an emptiness, but simply displacing it into an ever elusive ambition of becoming someone better or of transcending themselves. They spend their entire life leaving a place without really fully understanding the place they are trying to leave.
As the now deceased psychoanalyst Karen Horney has written about in her excellent book “Neurosis and Human Growth”, many people lose themselves in the empty pursuit of a never-ending self-improvement, and end up living an entire life trying to become someone other than themselves. They lose their life on what she calls the altar of glory, that is, in the pursuit of a better version of themselves that is really just another way to abandon a confrontation with the hurts of their own past.
The outcome of such a driven pursuit to simply move on without fully understanding that from which one is trying to move on, is a loss of a kind of happiness that comes from feeling rooted in one’s history and grounded within oneself.
The Price We Pay for Trying to Escape from Our Past:
So many people nowadays come to therapy complaining that they don’t really know what they are passionate about, or saying that their lives feel meaningless. Maybe they report feeling like a machine, and not really having access to the flow of emotions that would make them feel alive. Or maybe they report feeling lost and confused, empty inside, and in search of a purpose.
These are the symptoms of leaving without first arriving.
They announce to us that we are not in touch with ourselves, that we have taken leave of ourselves before first accepting the struggles, traumas, memories, or feelings that would allow us to work through our issues without abandoning ourselves. They are signs that we have attempted to leave ourselves by numbing ourselves, tuning out, avoiding, or prematurely conforming. They are signs that we have paid the price of trying to get somewhere safer and better by leaving our “luggage” behind or by leaving painful pieces of ourselves behind in our unprocessed and unresolved past.
But we can’t leave a place simply by avoiding it. We must first “say our goodbyes”.
Leaving Pain Behind Is an Active Process:
Truly leaving a place that feels unpleasant, overwhelming, shaming, or traumatic is an active process of facing and confronting that which haunts us.
To face and confront a belief about oneself, an emotional reality, or a painful memory we must first accept it.
Only when we accept that which we have tried to leave behind can we begin the active process of mourning our losses, shedding our tears, developing compassion for ourselves, or expressing anger at others for what we needed from them but never got. This kind of emotional repair work is only possible when we truly arrive at those places which we wish to leave behind.
Leaving can now become an active emotional process, rather than an avoidance that simply shuts out by shutting ourselves out.
Experiencing Transformation Through Our Emotions:
In the realm of emotions, getting away from something is paradoxically only possible by going into it.
Only by going into that which is unpleasant or overwhelming or distasteful, do we realize that we can come out on the other side with new realizations about ourselves. If we truly enter into our emotions, like one would ride a wave, we will see that emotions have a way to carry us to new shores. They don’t have to become stuck places in our lives, but can be starting points for truly working through sadness, anger, loneliness, and despair.
“Where something becomes extremely difficult and unbearable, there we also stand already quite near its transformation”
And transformation through going through the motion of our emotion is exactly what is needed in order to leave a place.
Discovering the Joy of Our Aliveness:
By working our emotions through to completion rather than short-circuiting them in an effort to leave them behind, we can let our suffering transform us and in turn transform our suffering.
Diana Fosha, for example, has found that clients who truly work through their emotions in therapy, experience a variety of transformational affects, like a sense of mastery, curiosity, confidence, joy, pride, and compassion. People report feeling moved and touched, or experiencing amazement and wonder. They no longer feel weighed down by the pain, or blemished by their past, but instead feel “lighter”, shed tears of joy, and get filled with tenderness toward themselves and others.
These kinds of shifts are signs that we are rediscovering who we really are instead of spending our life running from ourselves. They are signs that we are getting in touch with an aliveness and resilience within, and that growth brings about a joy that avoidance can never obtain.
They are signs that we are finally leaving a place that we have truly arrived at, and that we no longer have to abandon ourselves in order to find peace and comfort with who we are.
About Me: I am Rune Moelbak, Ph.D., Psychologist in Houston Texas. I help people arrive at their past so they can truly leave it behind instead of spending their life running from themselves.
No feeling is so painful as the pain of the human heart…
One client of mine, when asked what it was like to feel shut out and rejected by her partner, used the word “soul-crunching” to describe her pain
In fact heartache and heartbreak are often described by people through metaphors of brokenness.
Heartache and heartbreak literally destroy something inside of us. We feel as if we have fallen to pieces, as if our lives are in ruins, and as if who we are and what we live for is no longer intact.
What Science Says:
Research shows that heart-ache and heart-break are not just painful experiences metaphorically speaking, but that they literally impact the same parts of the brain as physical pain. So when we say our heart is hurting, it literally is.
What You Need to Know about Heartache and Heartbreak:
Heartbreak, which describes the pain of a break-up, and heartache which is a more general description of the pain in the heart we feel when someone we love dies, are similar in many ways to the term “psycheache” which is a term used to describe the pain of being alive often reported by people who are suicidal.
All three terms express a pain of existing which only humans can feel. And there are really only two responses to deal with it. We can shrivel in the face of it and try our best to avoid it, or we can enter into it and become wiser from it.
The Two Ways to Deal with the Pain of a Broken Heart:
Avoiding the Pain:
The pain of heartache and heartbreak is so difficult to tolerate that our natural instinct is to want to run from it.
We run from the pain in different ways:
If we have just broken up with someone who matters a great deal to us, it might be tempting to simply get involved with another person and skip the the painstaking process of grieving the loss. However, a broken heart is not ready to love again before it has healed, and healing takes time. This is why a rebound relationship is never the best way to deal with a broken heart.
Another way we may distract ourselves is to simply keep busy and try to distract ourselves through activities, projects, work, or being social. In this approach, we simply try to never be alone or never fully stay long enough in the moment, to truly feel our pain. Of course, such a flight from ourselves, is bound to fail in the long run. Since we are not really dealing with the pain, the healing process never really begins, and we just end up postponing the inevitable.
A third way to deal with gut-wrenching pain is to shut the grieving process down by numbing ourselves to our emotions and hardening our heart. The pain of living is here dealt with by becoming a little less alive. While this might feel preferable to feeling the pain of existing, the long-term price of this strategy is steep, and we often end up feeling alienated and cut off from everything good life has to offer.
Learning from the Pain:
Because every attempt to simply avoid our pain is destined to fail in the long-run or to come with a heavy price tag, a wiser path to follow is to heed the message of the broken heart itself.
If you do this what you will discover is the following: Your heart is broken because you dared to love and let others matter.
Now in the absence of your loved one, you have lost a piece of yourself and are no longer whole. Your existence, without the other person, no longer feels full or sufficient. Love opened up life’s riches, and now that it has closed these riches down, the pain you feel is the pain of the absence and meaninglessness of a life without such love.
And although your heart is trying to warn you not hurry back into the same kind of vulnerability that left you bereft, it has also just revealed the meaningfulness, joy, and value of a life of mattering to someone and letting someone matter to you.
Its message is therefore not to avoid loving, but to take the time to reflect on the big questions brought about by the encounter with the inevitable pain and joy of an open heart.
What has loving and losing revealed to you about what is really important in life?
What has it revealed to you about yourself and about others?
Did you make mistakes and do you have regrets?
What lessons can you carry with you into your next relationship?
Only if you fully go into these often painful and quite dizzying questions about the meaning of your life, do you unlock the wisdom contained within your heartbreak.
Then you will live to love again, and be a little more prepared for the inevitable heartaches and heartbreaks of life.
Empty Hearts and Full Hearts:
As Jon Fredrickson, a social worker and practicing psychodynamic therapist has said:
The person whose heart has been broken and gives up loving ends up with an empty heart.
The person with a broken heart who continues to love has a full heart, knowing that everyone we love we lose through death or abandonment.
That is why there are only two kinds of hearts: empty hearts and loving hearts.
It takes courage to face the inevitable losses and yet, in spite of it all, to keep on loving and being open to life
About Me: I am Rune Moelbak, Ph.D., psychologist and psychodynamic therapist in Houston Texas. I help people move through their difficult emotions to find greater peace and comfort with who they are. Visit: www.bettertherapy.com for more information.
At my last visit to my hair stylist, I happened to pick up a recent copy of a glamour magazine and haphazardly flipped through the pages, mostly out of boredom.
Although I know I did not exactly have a Eureka moment, I was struck by the fact that in image after image, as I perused the pages, I saw only smiling faces. These looked like people who were having the time of their life and who had discovered the closest thing to the bliss the Buddha was talking about.
For some reason my eyes were drawn to an article about Joan Collins, the famous Dynasty actress, who apparently has a quite enthralling estate in France. She showed it all to the reader with her smiling “hubby” by her side.
It struck me how alluring this depiction of life is. These are people who have it all. They have become the image of what so many people strive for: happiness, success, beauty, wealth, everlasting love.
And yet as I began to look closer, I noticed sudden cracks in the image of perfection. Joan Collins is aging and reminding me that the Joan Collins of Dynasty is a mortal. You could notice the faint contours of liver spots on her skin and none of the make-up could conceal her many wrinkles. I was particularly attuned to her signs of aging, because I myself recently had to come to terms with the inevitable loss of youth. Noticing my first gray hairs and the beginning signs of balding have recently forced me reckon with the fact that I am middle-aged, not everlastingly young.
The Illusory Pursuit of the Image:
Why is the idea of the image such an important source of allure and suffering in human existence?
The allure of the image is in some sense the allure of something eternal and unchanging; some kind of end state that we can arrive at or merge with.
An image, like a photograph, is immutable, just like a concept or an idea. It is in the realm of images that we can imagine things like true love, everlasting beauty, success, and so on. In the realm of the image, these are attainable states, or qualities people can possess, and we often aspire to merge with these attributes, to become them, or acquire them.
And yet life as the Buddha reminded us is not static, but always changing. Nothing ever stays the same. We never stay the same. And so the image in human existence is really an illusion. It is an aspiration Sigmund Freud might talk about as adeath instinct: the desire to return to a non-human form, which is really antithetical to life.
The Image and Jaques Lacan:
Psychoanalyst Jacques Lacan talked a lot about the problems that come from identifying ourselves with an image. He pointed out that our internal experience is really quite shifting and fragmented, but that we learn to identify ourselves as a thing in the world through having our image reflected back to us in the mirror or by other people. He identified a specific developmental stage around 6 months of age when the child first begins to think of him or herself as that person in the mirror.
The problem with this identification is that it betrays a truth about us, which is that we are never really a unitary whole, never really fixed in our nature like the image would convey. The pursuit of becoming a static image therefore is at odds with life and a source of great suffering.
Lacan pointed out that what distinguishes us as human beings is that we live in a symbolic reality, or a reality of meaning, and this fact is both what makes images possible, and robs us of ever becoming one with them.
Words, like mathematical symbols, are never fixed in what they refer to: 1 + 1 can apply to apples as well as people, and the word “successful” can be attached to multiple different images, and can even mean different things at different times for different people. This slippery nature of symbols means that we never quite arrive at the final destination that we can dream about or aspire to: The idea of something, and the experience of that idea never quite merge. Because the symbol offers us a meaning rather than an “edible”, there is never really anything at the end of the rainbow. We can never really sink our teeth into the image.
Learning from Celebrities:
This is probably also why there are no shortage of examples of people who seemed to have it all but who ultimately ended up self-destructing. Elvis Presley, Marilyn Monroe, Michael Jackson, Eazy-E, or even Brittany Spears all ended up discontent and unfulfilled. Perhaps what is different about them and the average Joe is that they were forced to confront the fact that the image always alludes us.
Many people find solace and hope in the dream about the image. How often don’t we hear people say things like: When I win the lottery I will quit my job and move to the Caribbean. They have the comfort of a different life as a possibility: the life they read about or dream about.
But people who have actually lived the dream, and still find the image eluding them are in a different quandary. Either they have to up the ante (such as perhaps run for president once they have already proven that they are successful in business) (wink wink), or confront the truth that images are illusions, and that life will always rob us of the satisfaction that would come from merging with our dream.
Perhaps that is why Elvis Presley, Marilyn Monroe, and Michael Jackson turned to drugs. They had to find a way to escape the realization that they couldn’t run from themselves. That at the end of the day they are mortal, they age, and they don’t get more than simple and temporary enjoyments from the images they so want to be.
A life in pursuit of an image is in this sense a wasted life, because it is the pursuit of something that can never satisfy, or that is always elusive.
The Take Away:
As people we are ever changing, and we are different from the still perfection of the images we see around us on TV, hear about from others on Facebook, or attribute to others based on their appearance or our own projections.
I will not say that I have attained the wisdom to live my life in accordance with this truth, but life teaches us this lesson sooner or later, as my own confrontation with aging has made it apparent.
The only question left for us to wrestle with is whether we can accept this fact, or want to spend our life fighting it.
About Me: I am Rune Moelbak, Ph.D., a psychologist in Houston, TX. I help people find ways to be more authentically themselves. Visit my website: www.bettertherapy.com to learn more.
In this comprehensive, yet simple and practical, self-help guide, I will give you an overview of fifteen of the most effective techniques psychologists use to help their clients overcome depression.
Let’s go through each technique one at a time:
1. Get Active:
When we become depressed our body often starts to shut down. We become lethargic, don’t want to do anything, and feel like every little task is a hassle. To counteract this tendency, behaviorists have long suggested that one of the best ways to fight depression is to get your body reactivated.
One way to do this is to exercise. When you exercise, your body releases endorphins into the blood stream and this produces a calming effect. You might even consider lifting some weights since the succession of straining your muscles and relaxing your muscles mimics another psychological technique to calm the nervous system called progressive muscle relaxation.
Even if exercising seems like too formidable a task at first, start out by just going for a 30 minute walk, or getting out and about in small ways, even if just to run errands. Any activities you do outside the house will help to make you feel that you are accomplishing something, and will counteract the vicious cycle of shame, guilt and inadequacy that comes from procrastination, sitting around, sleeping, or giving up.
The behavioral approach to fighting depression very much prioritizes doing over thinking and feeling. Even if you don’t feel like doing something or can think of many reasons not to, if you participate in activities, these behaviors will bring rewards and will ultimately change how you feel and think.
Think of it a bit like getting into a new series on TV or reading a novel. You sometimes have to just get started, in order to eventually get interested, and subsequently have an internal motivation to watch another episode or read the next chapter. What matters is taking the first step.
Watch a video on progressive muscle relaxation to try it out now:
Les Greenberg who has studied the change processes in therapy has identified “changing an emotion with an emotion” as one of the key principles of change.
If you are feeling sad, for example, that emotion which alerts you to a loss or absence of something you want, also contains a potential for getting in touch with other emotions, which will change the nature of your sadness.
You may for example access your anger about what you have lost or wish you had. This would mean turning the sadness outward and expressing your indignation at the people who were not there for you and the injustice of things not going your way. The anger that can be healing is righteous anger (or standing up for yourself), not sad angry complaining, but this is something we will come back to later in this guide (See principle #6: Be Assertive).
The sadness you feel can also be transformed through a grieving process which allows you to actively let go of what will never be or what is forever lost. Oftentimes people stay captive in a depressed state because they are not able to accept their reality. They continue to wish that it be different. Grieving allows you to move on and focus on building a new reality (See principle #14: Mourn Childhood Losses).
By going into your emotions, rather than avoiding them, and by accessing another emotion that is contrary to or different from the original emotion, you can transform how you feel.
Marsha Linehan, has made this one of the general principles in her Dialectical Behavior Therapy. She recommends that when you are sad, you watch something funny on TV, or when you are angry, you engage in charity work. She calls this principle “acting opposite your emotion”. Some might consider this “fake” or “inauthentic”, but that would assume that you consider your real self to be static or equal to your current emotional state. Research, however, shows that we have many selves and that different emotions organize and mobilize different versions of ourselves. That is why, an introverted person, can become extroverted in certain environments and at certain times, or why you can feel different about yourself around strangers than around friends.
Here is a tutorial on using the “Opposite Emotion” Skill as one of the ways to fight depression:
3. Challenge Your Negative Beliefs:
When you are depressed, your emotional state often hijacks your thoughts. You feel sluggish and you think to yourself “I am so lazy, so useless, so worthless”. These thoughts then make you feel even more hopeless and depressed. One way to actively battle this self-reinforcing downward spiral is to catch your thoughts and challenge them by using logical evidence to assess their truthfulness.
First you write down the things you tell yourself that make you feel down. Then, when you have become aware of the specific statements that run through your head, you subject your thoughts to what we can call “thought court”.
A thought court is a way for both the prosecutor and the defender to have their evidence heard so that we can better arrive at a true verdict that takes all the evidence into account,
In this case the prosecutor is the self-critical voice that tells you many negative things about yourself. We want to hear the evidence the prosecutor can submit to support the negative claims, and we want you to write it all down.
However, we also want to hear from the defender, who in this case would be the more positive voice that looks for exceptions or evidence to the contrary.
When looking at and comparing both sides, we can then arrive at a more factually and logically accurate verdict, and can write down a new thought which is more balanced and fair.
To get started with the exercise, take a piece of paper and draw separate columns. In one column you write down the evidence for what you are telling yourself (the prosecutor), in another you write down evidence against (the defender).
You have to imagine yourself making a case for and against your judgment of yourself in a courtroom in front of a judge. This means putting forth your strongest evidence for and against, and really trying to prove and disprove your case. Then when you have all the evidence lined up side by side, you have to take both sides into account and formulate a thought or judgment that is more accurate and more fair. When looking at the evidence, your thought “I am so useless”, might change into “sometimes I feel useless, but there have been many times when I have added value and contributions to others”.
The goal of the exercise is to demonstrate how thoughts influence the way we feel, and how we can change how we feel, by thinking in a more fair and balanced way.
You can make a copy of the following thought record to get started, or you can click the link below to download it:
This principle is closely related to the previous, but worth considering in its own right. When emotions take over your thinking, you are prone to base your self-assessment on faulty logic. One of the best ways to fight depression is consequently to examine the faulty logics that are contributing to making you feel bad about yourself.
Cognitive therapists have identified a whole catalogue of faulty logics depressed people use. These include:
All or nothing thinking (losing the ability to assess yourself as falling somewhere on a continuum, rather than belonging definitely to one category or another, F.ex: There is nothing good about me)
Mind-reading (assuming you know what another person thinks, feels, or intends, without checking with that person: F.ex. this person doesn’t like me, I just know)
Mental filter (ignoring any evidence that would dispute your conclusion. F.ex. ignoring the A you got on an exam, and focusing only on the C you got on another)
Jumping to conclusion (drawing premature conclusions and leaving out consideration of other possibilities. F.ex., he did not respond to my text-message, so he does not like me).
Noticing when you engage in such faulty logic, will help you when you challenge your negative beliefs (see principle #3), and will allow you to step back from your emotional conclusions rather than be swept up in them and treat them as if they were truths.
A list of some of the most common logical errors are reviewed below:
Emotions are appraisals of an environment in relation to one’s needs. They tell you whether or not things are going your way or getting in your way. When you get lost in your anger, your loneliness, or your sad complaints (blame), without fully understanding what it is you need, and why it is that your life situation is being given a negative emotional appraisal, you end up getting stuck.
However, every emotion gives you information about what it is you value, want, or need, and if you can get in touch with that, you will have more agency and control over getting what it is you really want. One of the ways to fight depression is therefore to unlock the unfulfilled need contained in your emotional frustrations.
For example: If you are stuck in a kind of grief that doesn’t seem to get better or resolve itself, it may be because you are reluctant to let go of the comfort and safety that comes from holding on to a loved one. You may be afraid of finally letting go, because you are afraid of the pain of feeling abandoned and empty. Your stuckness in grief reveals to you that you have a need to feel loved and held. This awareness might spur you to more actively pursue ways to feel loved and held by other people in your life, which can then free you to finally grieve your loss.
Another person might be stuck in the angry complaints against their romantic partner for being inconsiderate or absent-minded, but the angry complaints at feeling wronged might obscure the sadness and longing that comes from the need to feel close.
Once you realize what it is you want or what it is you are missing, you can more directly ask for it or attempt to achieve it. You can then get unstuck from an emotion that will otherwise linger because it can’t achieve its aim.
6. Express Your Anger and Be Assertive:
An old theory of depression is that it is anger turned inward. Although this is somewhat simplistic, it is often the case that people who feel guilty or fearful of asserting what they want end up feeling passive, sad, and unhappy. Depression can therefore often be a sign to you that you are not standing up for yourself on issues that really matter, or that you are not allowing yourself to set an important boundary. One of the best ways to fight depression is therefore to become more assertive and explicit about your needs and wishes.
It is important for you to realize that anger is an important emotion that helps you realize when your needs are being frustrated. Only if you can allow yourself to feel your anger, can you examine what needs might not be met and take action to correct a bad situation.
Some people are scared of anger because they associate it with being out of control, violent, or destructive, and they may think of it as antithetical to maintaining strong bonds with others. They may fear that if they express their anger, others will leave, get annoyed, not care anymore, and so on.
The truth is, however, that anger comes in many forms, and does not have to be destructive if handled skillfully. There is a difference between angry complaining, and righteous anger, and between aggression and assertiveness. In the one situation the anger blames and destroys, whereas in the other, the anger asserts and conveys confidence. Learning when and when not to trust and express your anger is a necessary skill for you to learn if you don’t want to live a passive life.
Here is a workbook I recommend that will help you find ways to become more assertive in your life:
We often grow up thinking that parts of ourselves are not acceptable or good enough. These kinds of experiences of being flawed or not possessing certain traits, can often lead to a pursuit to become someone we are not.
Many people end up living lives that attempt to make up for a perceived flaw. If you felt different from your peers when you were growing up because your parents lived in a trailer park, you might feel compelled in your life to compensate for this perceived inferiority, by measuring your self-worth against how much money you are making in your career. Your life might become a compulsive pursuit of status and prestige, but inside you are still that wounded child who just doesn’t feel good enough.
Many people pursue some ideal version of who they want to be that simultaneously passes judgment on who they really are. Because they are not accepting themselves, but always have to be better, smarter, richer, and so on, they are destined to live a life of dissatisfaction.
Karen Horney, has written an excellent book about all the ways we attempt to make up for our perceived flaws through what she calls a “pursuit of glory”. I recommend that you read it if you find yourself having impossible standards that you continue to resent yourself for not living up to.
When you are depressed you often don’t feel like getting out of the house or doing anything. You just want to stick your head under the covers and disconnect your phone line. However, there is good evidence that if you fight this urge to withdraw from the world and force yourself to get out and to do things, you will start to feel less depressed.
In behavioral activation therapy depressed clients are coached to schedule at least one activity every day that involves getting out of the house, and doing something active, even if they don’t feel like it.
You can keep the activity small at first, so you don’t feel overwhelmed, but you do have to commit to it and give it a shot.
Start with an activity of 30 minutes that you could possibly imagine would give you some joy. Perhaps go for a walk in the park, go get an ice cream, go to the library to look for a book that might interest you, treat yourself to a café latte in a coffee shop, or take yourself to the movies.
The important point here is that you don’t need to “feel like” doing it, but simply agree to do it anyway and treat it as an experiment.
The experiment is to compare how you felt before you did the activity and how you felt after doing the activity. Be a scientist and rate your depression from 1-10 before going out and do the same after returning. Now see if there is any change in your score. My best bet is that you will feel less depressed after doing the activity, not more.
Over time, you can increase the time or frequency of the pleasant activities you put in your schedule, but the important thing is that you stick to your plan even if you don’t feel like it.
Try to follow this advice for one week and schedule one pleasant activity for each day of the week. Then assess how it went and compare how you felt at the beginning of the week and at the end of the week.
Depression often goes together with feeling worthless or ineffective. An anti-dote to this feeling is to do something you feel good at. The sense of accomplishment and mastery that comes from a job well done will help rebuild your confidence and is one of the best ways to fight depression.
Remember to leave your all or nothing thinking at the door: You do not need to be good at everything in order to grant yourself a victory. If you are having a hard time remembering something you do particularly well, think back to earlier times in your life when you felt accomplished, or when somebody said you had a talent or knack for something.
Even if you come up empty, you can still give yourself an experience of success simply by thinking of a small project to complete: Clean your living room, look up a recipe and bake a cake from scratch, take care of some pending issue like getting your driver’s license renewed or following up on an e-mail you have been putting off.
You might not feel like doing it, but do it anyway, and make it manageable enough not to overwhelm yourself.
For starters just do one activity each day, and remember to pad yourself on the back and enjoy the fact that you accomplished it.
Challenge any negative thinking that tries to minimize or undo your accomplishment. At the end of the day, you are better off now than you were before.
10. Express Your Emotions:
Thinking and feeling things on your own is not the same as expressing them to others or even writing them down in a diary.
Something happens when we express ourselves that is very healing. Oftentimes we discover what we feel when we talk. We often don’t know what we think until we see what we say. This is in large part why psychotherapy is so healing. It helps us discover ourselves through talking, which gives us a better sense of ourselves and how we feel.
Of course there are other benefits to expressing yourself as well. If you open up to a trusted person it gives you the opportunity to feel validated, understood, and heard, and this in turn may make you feel more normal. It may help you to get your need for closeness met, and may give you the opportunity to ask for what you need.
If you don’t readily have other people available whom you feel comfortable opening up to, you should consider writing your thoughts and feelings down in a journal, participating in on-line forum, looking for meet-up groups to join, calling a hotline (or chatting online), or finding a therapist to talk to.
You can also get involved in charity work, which will help you take your mind of yourself, while building connections that might turn into lasting friendships. One good place to look for volunteer opportunities is: Volunteermatch
Open Path Psychotherapy Collective is a directory of therapists who offer low cost counseling:
11. Learn to Forgive and Move On:
Many people end up being angry and sad about what they wish were different but can’t really change. Maybe they wanted a different father who was more involved in their life, or maybe they continue to feel they can’t meet the expectations of their mother, whom they wish would love them for who they are and not for their accomplishments.
In many situations such as these, people don’t fully move into the loss, but continue to protest the loss. They become stuck in their sadness and anger (often an undifferentiated mix of the two), and are unable to go through the grieving process of letting go.
Emotion research conducted by Leslie Greenberg shows that the way to facilitate the grieving process is to fully experience and express the anger and sadness you feel so you can more fully understand what you lost and what need was frustrated.
Once you have fully understood this, you then need to move into an understanding of the limitations of the other person who did not provide you with what you needed.
A good way to accomplish this is to try to enter into the other person you are angry with or hurt by, and to view them like you do when you are most angry or most sad. Then you write out what you imagine them thinking and feeling, speaking as if you were them.
Inhabiting the voice of your critical mother, you might for example write: “I did not love you. You were never who I wanted to have as a child”. Continue to write until you get it all out.
Then once you have written out what this critical/ abandoning mother would say, you shift back into your angry/ sad self and express how the critical mother makes you feel. You continue to use a 1st person voice and this time you try to get in touch with what you really needed and did not get from your mother. You might for example say: “You really hurt me when you don’t accept me (sadness)” or “I hate you for never appreciating me” (anger). Again, continue until you have written out everything you are angry or sad about.
Then you switch back to being your mother again, and try to imagine how she would respond to knowing about the pain she caused you. You might for example say: “I never meant to hurt you this way. I was going through a difficult time in my life and I did not know how to show the love you deserved. I tried in my own way to love you, but I realize it wasn’t good enough”. Try to enter fully into the regretful and compassionate voice and perspective that might be evoked in the other person if they truly understood how they impacted you.
Finally, you switch back to being yourself again and write out a response that indicates whether or not you can understand where the other person was coming from and can take in their new message. In this case, you tell your mother whether or not you can hear that she is regretful and feels bad. You also express whether or not you can forgive her and accept that she did in fact love you, even if she did not always know how to show it.
Switching roles between yourself and the other person, and writing out the dialogue using first-person voice, is a version of the empty chair technique used by emotion-focused therapists and gestalt therapists to help clients resolve unfinished business.
Example of the empty chair technique to resolving unfinished business:
12. Examine Your Relationships:
People don’t exist in isolation and how we feel about ourselves often depends on how others treat us. We all have a need to have parts of ourselves we cherish seen, understood, and validated by others. If it is important to me to feel valued for my intellect, then I need to feel like others around me think I am smart. If it is important to me to be seen as helpful, then I need to surround myself with people who view me as kind and considerate.
Oftentimes, we begin to feel depressed or unhappy when the people we interact with don’t view us the way we would like to be viewed. Maybe we are in an intimate relationship with someone who always complains about our shortcomings, or maybe we have friends who take advantage of us or treat us with disrespect.
One of the ways to fight depression is therefore to take an inventory of the people you spend time with and ask yourself: Are these people good for my self-esteem, or do they drain me or make me feel bad about myself?
Then make a decision to either cut people out who bring you negativity, or to talk to them about what you need from them, or what you don’t like about your respective roles.
As with any confrontation, it is much better to keep the focus on your own feelings and needs than on what the other person has done wrong. Use “I” statements rather than “you” statements. Express how you feel, rather than what you think about the other person. Approach the other person in a soft and vulnerable way, rather than in an angry and attacking manner.
13. Practice Self-Compassion:
Many people who are depressed are very unforgiving of their own mistakes, but very compassionate and understanding of those of others. You might have a critical voice inside that tells you that what you do is never good enough and keeps beating you up about past regrets.
One way to challenge this negative self criticism is to deploy technique #3: Challenge Negative Beliefs.
Another is to practice self-compassion.
Self-compassion means adopting a loving and caring attitude toward yourself that is similar to the one you would adopt toward a good friend or someone you love. It is a way to remind yourself that you are human, have frailties, and make mistakes, but that you do the best you can given your circumstances, and deserve to be loved even if you make choices you are not proud of.
The Self-Compassion website by Dr. Kristin Neff contains 8 different exercises to cultivate a kinder and more accepting attitude toward yourself.
If you find yourself not feeling worthy of compassion or feeling too hateful toward yourself to attempt any of these exercises, try to imagine a kind and wise friend who cares about you unconditionally.
What would this friend tell you when you begin to slide into shame and start attacking yourself? Can you remind yourself that all of us have regrets, fears, and struggles? Can you step back from the flow of your thoughts and emotions to recognize that your suffering connects you to the rest of humanity, knowing that all human beings feel pain, guilt, and regret?
One way to get more comfortable with having loving and kind feelings toward yourself is to engage in meditative practices, such as the Self-Compassion meditation illustrated in the video below:
Some psychologists think of depression as the lack of acceptance of the full scope of all your feelings. According to psychologist and psychoanalyst Alice Miller, for example, depression is what happens when we attempt to escape from the childhood pain of not being acceptable in some way by trying to become what others want us to be.
Maybe we learned that our laughter was too loud, that our needs were too great, or that our anger was too destructive, and the implicit message we got was that our parents would not love us if we didn’t get rid of these impulses or feelings.
The fear of losing affection therefore started to overwrite our natural need for self-expression and we became more concerned with emotional adaptation than with fully being ourselves.
The problem is, however, that many of us keep on living our life as if we could redeem ourselves and gain the approval we were missing in childhood simply by being different. We still try to win our parents approval, even though the approval we are seeking is an approval we needed in the past. The loss of love we were seeking has already happened, and no effort can change this fact. Instead of chasing a way to redeem ourselves or repair an old wound, we are therefore better off grieving the loss and letting go.
This might sound depressing, but it really isn’t. Only when we can allow ourselves to truly mourn our losses can we get unstuck from the dynamic of trying to gain approval by being someone other than who we really are.
The opposite of depression is not happiness, but vitality, which means the freedom to experience all of life’s emotions and urges, including those which we previously wanted to push away.
Being able to experience envy, jealousy, rage, disgust, greed, loneliness, sadness, and despair, means being whole, and being whole means living life fully and being fully human.
As one psychotherapy patient tells it to her psychoanalyst:
It was not the beautiful or pleasant feelings that gave me new insight but the ones against which I had fought most strongly: feelings that made me experience myself as shabby, petty, mean, helpless, humiliated, demanding, resentful, or confused; and above all, sad and lonely. It was precisely through these experiences, which I had shunned for so long, that I became certain that I now understand something about my life, stemming from the core of my being, something that I could not have learned from any book!
(Quote from: The Drama of The Gifted Child)
If you would like to read more about grieving your childhood losses so you can be free to be yourself, I recommend the following highly acclaimed book by Alice Miller:
15. Face Your Fears:
One of the ways depression can look is as a pervasive sense of indifference, lack of interests, and lack of zest for life. Some people feel empty, don’t know where they are going, have few or no opinions about matters around them, or avoid close encounters. They are emotionally shut down, alienated from themselves and others, and say they feel numb or that life feels like they are just going through the motions.
Oftentimes this anhedonic type of depression is fear-based. People shrink from life or shut down their emotions because they encountered situations in their life that were too emotionally overwhelming, and too frightening to deal with at the time. This could either be due to a specific traumatic event, such as violence or abuse, or due to a silent suffering such as emotional neglect or abandonment.
Whatever may have happened, the person learned to survive by getting rid of emotions that were too unpleasant, by lowering their expectations of life, or by not risking the rejection and disappointment that comes from getting excited or caring about something.
Sometimes working through traumatic events requires:
#2 Changing an Emotion with an Emotion
I have described how this works in the case of a trauma, in the following article:
At other times you may confront irrational or unfounded fears head on using something called exposure therapy:
Exposure therapy helps you take small calculated risks to confront your fears in a way that feels gradual and manageable.
If you are fearful of rejection, for example, you could go and ask out the most attractive person you know. But this would likely terrify you, so you have set yourself too big of a goal. On your exposure hierarchy asking someone attractive out for a date, might be the biggest challenge for you, and should be saved for last.
Smaller more manageable experiments would be to call up a friend you haven’t talked to for a while, or ask a colleague out for coffee. It might even be to say “hi” to a stranger or make eye contact for at least 2 seconds. It all depends on how big your fears are.
The goal of exposure therapy is to construct a hierarchy of activities according to perceived risk and difficulty that gradually helps you confront your fear of rejection.
Exposure therapy works because fear is just an emotion and emotions tend to decrease in intensity over time. By facing your fears, instead of avoiding things that make you afraid, you will gradually experience that you have “nothing to fear but fear itself” and that the actual situation is not that scary after all.
To learn how to construct an exposure hierarchy, click to download this handy guide by psychologist Danny Gagnon:
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One of single biggest issues that stops people from living the life they want is their inability to let go of negative memories from their past.
Most often when people experience hurtful events in their life they tend to prefer to suppress their memories, or to simply silence their emotional pain by trying their best to ignore what happened.
When you ask them about why they want to avoid revisiting their past, they often say that there is no reason to dwell on their memories, since there is nothing they can do about their past anyway.
They will say things like: What is the point of remembering your childhood sexual abuse? It doesn’t change anything about what happened. And why should I remember that I grew up with an alcoholic father? or a mother who abandoned me? Crying about what happened or didn’t happen would simply be wasted tears.
At first glance this way of thinking seems reasonable. And it would be a great solution indeed, if it were really possible to simply let go of the past like this. The problem, however, is that our body remembers, even though we don’t. What this means is that whatever unfinished business we have not addressed will keep getting activated and wreak havoc on our lives, until the day we really confront it and lay it to rest.
What to Do about Negative Memories from the Past:
The positive news is that there is a lot that can be done about unpleasant memories and experiences from the past. Although it is true that we cannot change the past, we can in fact change how feel about it and what meaning we attribute to it.
The best way to do so is to go back into the experience rather than to avoid it.
When you don’t shut down a negative or unpleasant emotional memory, but are helped to fully enter into it, you will be able to learn something from it. Emotions tell us something about ourselves and about our needs, and this information helps us transform our emotions by giving us access to other emotions.
How to Overcome Negative Memories of Childhood Sexual Abuse:
If you were sexually abused, for example, this memory is oftentimes initially experienced as unbearable, repulsive, or shameful. But if you enter into the emotion and get some help from your therapist, you will soon see that the initial experience of disgust, or pain, or shame, can give rise to a whole set of other emotions, which in turn change the overall meaning of the experience.
The emotion of shame, which causes you to want to hide, or the emotion of disgust, which causes you to want to push away, are often turned against oneself in people who were abused. They often think of themselves as “broken”, “damaged”, “vile”, “unlovable”. They sometimes want to hurt themselves as a form of punishment, or hide who they are from others because they don’t feel worthy of acceptance.
However, by fully going into these emotions, rather than shutting them down, the person may be able to access other facets of their emotional experience.
They may begin to access sadness at what was lost or what was taken away from them and to enter into the grief that was previously blocked by shame.
The sadness may in turn give rise to anger at the perpetrator for violating a helpless child, or at caregivers for not picking up on small signs that things were not okay.
As the person gets more in touch with their anger, this changes their sadness, by making them feel more empowered. In this way the person can go through a change process from initial shame or disgust, to sadness about their loss, to anger about what should have happened, but didn’t happen.
As they begin to feel more indignant at the other person, rather than blaming themselves, they may also better be able to soothe themselves or care for themselves. It is only a short step from “I was so helpless and alone” (sadness) and “it wasn’t right and shouldn’t have happened” (anger), to feeling compassion for one-self “I didn’t deserve it; it wasn’t my fault and I shouldn’t blame myself”.
By entering into the initial emotion, which was very unpleasant, it became possible to change the original emotion with another emotion, and thus to change the experience of the memory itself.
According to Les Greenberg this emotional change process will eventually lead to acceptance and agency. Once we accept who we are and what happened to us, and work through our feelings about it, we come out on the other side as feeling empowered and having a choice about how we want to move forward.
Instead of being stuck in a past that keeps wreaking havoc on our lives, we can now take control of our lives, give ourselves a pass, and orient ourselves toward the future with a renewed confidence and a more positive sense of self.
About Me: I am Rune Moelbak, Ph.D., a psychologist at Better Therapy PLLC. I help people experience change at an emotional level and overcome traumatic memories and experiences that are holding them back.
Many people feel marred by guilt feelings that are preventing them from fully enjoying their lives.
Sometimes, of course, guilt is a useful signal to ourselves that we have done something we can’t really be proud of or have done something we shouldn’t have. It allows us to to seek forgiveness and correct a wrong. Without this kind of experience, we would not be able to become remorseful, and would end up not caring about other people’s needs, thoughts, and feelings.
When Does Guilt Become Excessive?
Many times, however, guilt becomes attached to a wide variety of healthy feelings, thoughts, or behaviors, and starts to work against us rather than for us.
We may for example feel like we have done something wrong after having sex, or we may feel like we made a transgression by standing up for ourselves when we really needed to.
Because the feeling of being guilty of a wrong is so unpleasant, it is likely that we end up avoiding situations that would make us feel this way, or that we become apologetic and remorseful in situations where we should really stand our ground.
In this way, our guilt feelings can begin to control us, and can make us cut off pieces of ourselves and live restricted lives.
The Woman Who Was Consumed by Guilt:
One woman, for example, had the propensity to feel guilty about asking for what she needed in her marriage. She would not be able to enjoy a movie if her husband didn’t pick it, and would not be able to tell him “no”, if he asked her to take on responsibilities, which severely encroached on her other commitments and plans. On her birthday when she chose a restaurant for her birthday celebration, she could not enjoy the dinner because she was too worried about others not liking the restaurant she picked. In situation after situation, she would therefore avoid making a decision, or avoid telling others no.
At the end of the day she paid for her guilt-ridden existence by feeling “trapped” in her obligations and responsibilities. Her conscience had turned against her. Rather than being a source of good, it had become a cross to bear. She was living a life of repentance of sins she had never committed and had become imprisoned by the prohibition against making any demands or stating any wishes. Being herself had become guilt-inducing.
In this situation the woman’s guilt had become “neurotic”.
Neurotic guilt is guilt that has stopped serving as a useful moral compass, and has started to become aggression turned against oneself.
The voices of adults we internalized when growing up, and which helped shape us into a moral human being with empathy and consideration for others, has in these instances begun to over-function.
What is Guilt?
Guilt is in its essence the experience of remorse for having done harm to others by our actions, feelings, or thoughts.
In a supportive environment, we learn that even though we hit our little sister, we can seek forgiveness and can repair the situation. But if for some reason, the repair was not an option, or if others seemed to be excessively hurt by our expression of a thought, or our display of a particular emotion, the experience of guilt can find no release, and instead become traumatic.
One woman expressed how her father during a time of depression, had told her that the reason why he became suicidal is that he thought she did not love him. The woman internalized this message as a perpetual guilt about her actions and omissions. She started to feel that there was something destructive about expressing her needs or feelings, and that she had the power to destroy the people she loved, by the mere expression of her thoughts.
Other situations that can lead to excessive guilt are early messages that you will go to hell, or that mommy and daddy won’t love you anymore, or any other message that communicates the lack of possibility of redemption, or the withdrawal of needed love and affection. The guilt in these situations can become overwhelming, and so aversive that life itself, with its spontaneous desires and wishes, has to be inhibited.
The Cure for Excessive Guilt:
In the examples stated above, guilt in its natural state has really been corrupted by the experience of intense anxiety and fear, or by excessive pain, or even self-loathing.
To remove the excessive guilt is therefore to come to terms with these feelings or fears. In many situations, guilt or the anxiety associated with asserting one’s needs or wishes, are really rooted in a fear of one’s own aggression and the erroneous belief that there is something destructive about one’s needs and feelings.
Only when a person gets in touch with these underlying realizations and learns to undo the false impressions of their needs and feelings, can these feelings be transformed. A person can then be released from the chains of their excessive guilt and find peace and comfort in being who they are.
About me: I am Rune Moelbak, Ph.D., psychologist in Houston, TX. I help people undo negative learning from their past that has led to excessive guilt, shame, or anxiety. Visit my website to learn more.