Good Grief

Therapy is in part a dance of self-disclosure, an opportunity to reveal ourselves to another and – as one of my clients put it – “talk about things I don’t want to talk about.” In my practice at least, the self-disclosure is a two-way street; in developing a therapeutic relationship my clients get to know me as a real person with a real life, and learn at least some of the context of that life.

It’s a two-way street, but not an equally heavily trafficked one. When it comes to therapist self-disclosure, there are two caveats I try to always keep in mind:  1) the person who does most of the talking in the session is the one who’s getting the therapy, and 2) therapist self-disclosure should be undertaken in the service of the client, not the therapist.

I’m therefore pretty mindful of what, when, and how much I share with clients, and usually keep my disclosures to experiences I’ve had with other clients that I think might be instructive, or snippets from my own life that could inform what my client is currently facing.

Through the course of my career, there have been two occasions when the self-disclosure has been less controlled and less controllable: seventeen years ago, when my ever-growing belly announced that something was going on with me, and the past couple of months as I’ve been going through the process of grieving my dad’s passing.

The view from Kallidromos Mountain in Greece, near my father’s birthplace.

Birth and death. Seismic life events that break apart and then reconfigure every aspect of our lives. Both times I’ve felt the vulnerability of having a part of my out-of-the-office life follow me into the office, and the concern that its presence might hijack the session and compromise both my own and my client’s ability to put the focus squarely on them.

What I’ve learned (well initially learned, promptly forgot, had to re-learn) is that it is actually much easier and less distracting to acknowledge what’s with us and invite it out into the room than it is to try and pretend it isn’t there. Grief, fear, nausea, all emotions and sensations that seem to breed apace the more we try and ignore or deny them.

What I’ve also (re)learned is that therapy is at its heart a relational connection, and that a large part of the value of that comes from its being a two-way street. I’ve certainly benefited from that — I’ve felt cared for and supported, and watched clients who would describe themselves as undesiring or incapable of connection show tenderness and warm compassion.

I like to think my clients have also benefited, either from recognizing their capacity for responding to and empathizing with another, or from seeing that grief and loss is universal. We all experience it, we all benefit from having others (and ourselves) bear witness to it, we can all find a way to move through it.

What are you entitled to?

I was having a language debate with a friend the other day (because I’m fun like that), about the correctness of using ‘entitled’ versus ‘self-entitled’ to describe someone who has a sense of, well, entitlement.

As a character descriptor, entitled is an unpleasant word, it makes me want to back away from anyone to whom it would apply. It brings to mind someone who expects to be given what they want, and feels they can take what they want, whether that thing belongs to them or not. Someone who doesn’t respect others’ boundaries or personal space, and even fails to notice that others have boundaries and personal space.

My friend would agree with that definition, just name it self-entitlement, a term I hadn’t really heard before.

It made me wonder whether self-entitlement can come to mean something else, something that puts the emphasis on self rather than entitlement. What if self-entitled stood as a counterpoint to self-erasure and referred to someone who is centered in themselves, has self-awareness and practices self-respect, and does that in concert with their responsibilities to others, not in place of their responsibilities to others.


Reprinted with Permission, FowlLanguageComics.Com


I had that conversation with a client recently, as we looked at the ways we consistently put ourselves last, and sell it to ourselves as the expected or even noble thing to do. We silence ourselves in the service of being ‘nice’, we compromise our self-care for the sake of getting work done, we ignore our instincts and intuition for fear of causing someone else discomfort.

If you agree that acting entitled is off-putting and problematic, see how far to the other extreme your personal pendulum has swung — that too will be off-putting and problematic.

Are you too self-erasing and self-effacing? Are your commitments to yourself the first things that drop off the schedule when life gets demanding? Are you too quick to acquiesce for the sake of peace rather than owning that you are entitled (there’s that word again) to your own opinion?

If so, think about being a little more self-entitled. And if you’re challenged on the meaning of that word, engage in a lively and only mildly obnoxious debate!




Inside In

I’ve recently had the pleasure of spending more time with my father than the busy-ness of our lives usually allows, and it’s reminded me that besides being one of my favorite people in the world, my dad can also be a hugely entertaining story-teller.

He’s now approaching his 85th birthday, and somewhere along the line must have decided that I too am an adult, since I’ve been getting to hear an unadulterated and much more illuminating version of his life story. Here’s a recent exchange for example:

Dad: So your mom was really struggling and stressed out with the first baby. I didn’t know how to help her so I decided to get her pregnant with the second one.

Me: Uhhh…

Dad: You know, so she’d rest a little more. But the second one didn’t help at all.

Me: Wait, what??

Dad: Oh sorry, I forgot that you’re the second one.

Putting aside the convoluted decision tree that could possibly lead to “the best way to help a woman overwhelmed by the work of having one baby is to get her pregnant with a second baby,” thanks for filling me in on my origin story dad, it explains a lot!

My dad has had a rich and interesting life. He was born in a small village in Greece in 1931 and remembers World War II and its aftermath in Europe, as well as the culture shock of arriving in Canada in the 1950’s and working to build a new life here. He’s faced a lot of adversity and setbacks in his life, but the only time he gets emotional in the retelling is when he connects with the moments of kindness and generosity (from friends and complete strangers) that have also shaped his story.

I was struck by thinking that if I’m in his shoes one day, if my daughter is hearing my life story, it’s going to be markedly less interesting than my dad’s.


Reprinted with permission,


Not just because I’m a less entertaining story-teller (I am), but because the things that have challenged and confronted me in my life have largely not come from in front of me but from within me. While my dad’s tale would be classified as an action-adventure, mine would be more of a psychological thriller.

Acceptance and Commitment Therapy (ACT for short) argues that while our minds are well suited to assessing and solving external problems, at this point in human history we (in the 1st World at least) are most disturbed by the internal problem of holding difficult feelings and emotions, and it is this internal problem that causes much of our suffering.

For example, imagine this 1st World problem: “The lineup at this Starbuck’s is sooo long.” We can use our minds to solve this external problem by avoiding it. We can decide to forego the coffee altogether, or to seek out an alternate supply; problem solved!

We might also choose to endure the wait, in which case the external problem can become an internal one as well (the ‘problem’ of feeling bored, resentful, frustrated, etc.)  Our minds may once again come to the rescue, but when it comes to easing difficult emotional states, the mind’s solution repertoire can be limited. Mind can tell us to distract ourselves from boredom by going on our phone or daydreaming, or to ease our sense of indignation by staring down the barista as if she’s personally responsible for the line-up…

In this example, treating an internal experience as a problem isn’t particularly problematic (except maybe for the unfortunate barista being glared at), but a lived life offers no shortage of difficult emotional states: “My heart is broken, I can’t stand it.” “I feel so ashamed.” “I’m so scared, I’m paralyzed.”

While mind might say the solution to these negative emotions is to avoid them, ACT argues that it is actually the attempt to avoid them that causes the negative emotions to persist, and – more importantly – the time, focus and energy we’re putting towards the avoidance of emotional states is time, focus and energy we’re not using in the service of what we truly value.

I don’t doubt my dad has had many difficult emotional experiences to contend with in the course of his life, I am personally responsible for a couple of them. But whether by temperament or by circumstance, he takes a very ACT-endorsed approach to emotions: notice them, acknowledge them, feel them, and do all of that while you’re also doing what you were doing, unfolding the latest chapter of your adventure.



How You Doin’?

As much as I love reading about new ideas and exploring new psychological formulations, some of the books that have had the most lasting impact on me are ones I encountered early in my training. “We’ve Had 100 Years of Psychotherapy – And the World’s Getting Worse” by James Hillman and Michael Ventura is one of those books.

It offers a far-ranging dialogue between the two authors, one a Jungian psychotherapist and the other a journalist. As the title suggests, many of their conversations look at the larger impact of psychotherapy on our culture – who and how it’s helped, but also who and how it’s hurt.

Reprinted with permission.

They argue that one of the gifts of psychotherapy is that it encouraged awareness that we as humans are more than just biological beings; we are also minds, hearts, spirits and psyches, and all of those contribute to our sense of well-being. Conversely, they propose, one of the costs of psychotherapy is that we’ve forgotten we are also biological beings.

If you think back to the last time you felt dejected, irritable or unhappy, your mind may go looking for the thing that was the cause of those unpleasant emotions. It may decide your dis-ease was attributable to your job, your love life, your kids, your partner, or all of the above. While any of those factors may have contributed, your mood state could also have been influenced by a lack of sleep, an absence (or excess) of food intake, a need for fresh air or movement, or some combination of all of those.

This is something we seem to know instinctively when it comes to reading the moods of the young people in our lives. If they are cranky or out of sorts we will first consider “Is it her nap time?” “Does he need a snack?” “Have they been sitting in this car too long?” etc. Once the children in our lives reach adolescence, we add hormones to the list of suspects we consider when making attributions about the moodiness we’re witnessing.

As adults, aside from periodically attributing our moods to hormones if we’re women (or having others make that attribution for us), we rarely consider the other physiological influences that contribute to our mood states. We become more skilled (through practice) at masking our moods. We learn how to ignore hunger, fake cheeriness, and push or caffeinate ourselves through fatigue, but overriding our biological needs is not the same as not having biological needs.

So the next time you feel your mood state has taken a dip, treat yourself with the same care and consideration you would a toddler. Do you need a nap? Are you hungry? Have you been sitting in this car too long? The world may be getting worse after (now) 120 years of psychotherapy, but taking care of yourself from the inside out can help you feel better.

Hacking into your relationship status

Riding the elevator to work with a building-mate the other day, our chit-chat turned to a conversation about the Ashley Madison data release. For the uninitiated, Ashley Madison is a dating website that matchmakes married people looking for an affair, connecting them with each other or with singles wanting an affair with a married. It has most recently been in the news because its database has been hacked, and the threatened release of the names and details of its customers has now started to roll out.

Our conversation left me with two thoughts. One, I need to work on my elevator chit-chat game. Two, marriage counselling is a very different animal than I had thought it would be.

My building mate joked that the Ashley Madison data release would be “good for business,” reminding me of my own assumptions about what would inspire a couple to seek marriage counselling.

As a therapist in training, I thought the couples I’d be working with would be seeking help in the aftermath of a psychic ‘bomb’ hitting their relationship: violence, the revelation of an affair, a worsening addiction or mental health concern, or something equally catastrophic.

While that is sometimes the catalyst for couples seeking help, much more often the relationships I encounter are plagued by a more low-grade and chronic form of disconnect, a feeling that the closeness and interest in each other and in the relationship that they once had is now diminished.

In my experience, couples often fail to adequately notice the disconnect, until the day they realize it has resulted in a deep chasm of space between them, one that by the time it is seen can seem too big to bridge.

Unless you’re married to a sociopath, finding your spouse’s name in the Ashley Madison registry won’t be the first and only sign you get that your relationship is floundering.

Your first sign will be a measure of malaise seeping into the relationship. You’ll find yourself feeling impatient and intolerant of the quirks you once found charming in your partner, or catch yourself daydreaming about a different life with a different (less disappointing) partner.

You’ll notice that your conversations have decreased in both quantity and quality. You’ll have fewer discussions about your hopes, interests, fears, shared vision of the future, and more mundane ‘chore-talk’ about who will make dinner, what time the kids are being picked up, who will pay which bill when… You will laugh less and fight more, and those fights will become nastier and take longer to recover from.

Criticism, swearing, name-calling, and attacks on each other’s character will start to enter your disagreements, and your self-talk during and after a fight will focus on the righteousness of your own point of view while assigning bad intentions to your partner’s words and actions.

Research suggests that couples have been unhappy in their relationship for an average of 6 years before seeking help, and often approach marriage counselling as a last resort when conflict in the relationship has them on the brink of separation.

We also know that relationship counselling is most effective with early intervention, and that the most useful approaches to couples therapy have less to do with conflict resolution, and more to do with rebuilding a sense of connection and mutual warm attachment.

So before you search online to see whether your partner’s name is on the Ashley Madison list, search inside and ask yourself how your relationship is doing. If you’re not content with the answer, think about what you can do to rebuild the feeling of connectedness and engagement between the two of you.

Relationship counselling doesn’t have to be the hail Mary pass you throw when the clock’s winding down in the game. It can be a maintenance check-up, a place to reflect on the state of your union and apply any course-correction you decide you need.

Surprise, surprise!

I was recently reading an article about Tania Luna, who bills herself as a Surprisologist. She is a firm believer in the value of adding an element of surprise to life, and has built a company arranging mystery outings and events for people. By taking into account their personal likes/dislikes and comfort levels, she organizes unique experiences that remain a surprise to the participants.

The article got me thinking about the genesis of my own love/hate relationship with surprises.

The hate came first. When my family arrived in Vancouver when I was 7, we spent a couple of months living at my aunt and uncle’s house. Their teenaged son (no doubt protesting the addition of 5 extra people in his space) delighted in “surprising” my siblings and I by jumping out from behind furniture, or otherwise appearing in startling ways from unexpected places.

Congruent with their temperaments, my brother and sister responded to these surprises by screaming and then dissolving into laughter. In keeping with my own, I responded by developing a nervous tic and insisting on sleeping with my mom and dad.

To highlight the benefits of surprise, Luna says: “We feel most comfortable when things are certain, but we feel most alive when they’re not.”

There is no doubt I felt alive every time my cousin jumped up and yelled “Boo!,” and making Luna’s point that surprise enhances our ability to remember an event, this is the only thing I remember about our time living there. Luna emphasizes the staying power of memories of positive surprises, but the same tenacity holds true of negative surprises, which can throw us into a state of shock and harden a memory into a trauma.

For those who’ve been traumatized and those with more anxious temperaments, surprise is synonymous with threat; what we don’t know, didn’t anticipate, or can’t control feels menacing and dangerous and is to be avoided at all costs, even if one of those costs equals feeling less alive.

In her business, Luna strikes a balance between surprise and control by gathering information about her clients, ensuring that the adventures she crafts will be a stimulating stretch of their comfort zone without being so uncomfortable that “I never want to do that again” is the only take-away.

Since most of us don’t have access to a professional surpriser it falls on us to seek our own balance, pushing ourselves to stretch beyond the tried and true while also ensuring that the experience is enlivening rather than overwhelmingly noxious.

I remember a client who a few years ago decided to try and overcome the driving anxiety she felt as a result of an accident by driving across two provinces, in the dead of winter, with her mother in the car. She (and her relationship) survived the trip, but it was a long time before she once again had the courage to get behind the wheel.

Conversely, I’ve had clients say that they avoided therapy for years because the uncertainty of what they would talk about, how the therapist would respond, and what the experience might reveal was too much to confront.

Today, I love the surprise of encountering and getting to know a new client, or seeing where today’s conversation will take us with an ‘old’ client. And since none of those clients greet me by jumping out from behind the water cooler, I haven’t felt the need to bunk with my parents in years!

Got a Minute?

A couple of years ago I decided to go back to school and train as a nutritionist. True to form, my decision-making process around this undertaking followed my typical pattern: spend a long period of time thinking about whether or not to do something, make an impulsive (and usually late-night) decision to act, then have a little freak out as I wonder what I’ve gotten myself into.

The freak out around nutritionist training wasn’t about the outcome – I’ve long wanted to expand my knowledge in the area of nutrition and I knew that the school I’d selected offered a comprehensive curriculum – it was about the process. I wondered how I’d be able to add a challenging study commitment to a schedule that already felt overbooked.

Turns out I had a lot more “free” time than I told myself I had (all those reality TV shows weren’t watching themselves). With the external pressure of deadlines to meet and assignments to complete, I got a lot more efficient in the use of my time, and became the proverbial busy person who gets things done.

I often think about that when I’m talking to clients about self-care. I don’t imagine any of them are surprised when the topic of self-care is broached in a therapy setting, but as I start the conversation I can see the panic rising in their eyes: “I’m here because I’m already feeling stretched to the breaking point and you want me to add something else to my pile of ‘to-do’s?”

Well yes, yes I do.

When we think of self-care, what usually comes to mind are significant (and significantly time-consuming) things: attending a yoga class 3 times a week, having a daily exercise commitment, getting a massage, doing weekly meal planning and preparation, taking time for a silent meditation retreat or at least a hot bath.

All of those are good practices to aim towards incorporating, but fortunately when it comes to self-care a little can also matter a lot.

Writing in Psychotherapy Networker magazine, Ashley Davis Bush distinguishes between macro self-care (the aforementioned meditation retreat), and micro self-care, which consists of brief, targeted practices that we can incorporate into our daily lives. They are brief, taking no more than one or two minutes to complete, and targeted in that they target the central nervous system activation we’re trying to calm. Here are a couple she recommends:

  • Imagine That – Try this when you feel disconnected, anxious, spaced out, or melancholy.  Close your eyes and imagine yourself in a favourite place, feeling happy and peaceful. You can recall a place you’ve actually been, or imagine a fantasy place of calm and bliss. Summon as many aspects of the place as possible (sights, sounds, smells, temperature, tastes) and let these sensory cues come alive in your imagination. Breathe deeply and stay in your imagined oasis for a minute or two.
  • Wring it Out – At the end of the workday, try this as a way to release and relax before you leave your work day behind. Sit upright in a chair and slowly and gently twist your body to the right from your hips to your head. Turn around as far to the right as you can, imagining that you’re a sponge and are wringing out all the stress and tension you’ve absorbed in the day. Then repeat the process on the left side. When you’re done, shake your arms in front of you as you release the day’s work.

Each of these practices takes no more than a couple of minutes to complete. If the goal is to reorganize our neural pathways in a way that improves serenity and emotional regulation, the key is to repeat them daily. As Davis Bush writes: “Small and frequent works better to create desirable neural pathways than big and seldom.”

Are you an Empopath?

I have a penchant for making up words, a trait that is shared by many people in my life. My husband, for example, frequently gives me updates on one of our cats’ desires for ‘affectionation’ (always high).

Recently a client and I coined a new term – empopathy – to describe a particular difficulty he was experiencing. What is an empopath? If you imagine the ability to feel for and empathize with others as existing on a continuum, psychopaths perch on the outer edge of one end of the continuum. Empopaths sit (gingerly, quietly, without taking up too much space) on the other.

Psychopathy is characterized in part by an inability to experience empathy, resulting in a lack of the feelings of guilt or remorse that commonly ground interpersonal behaviour. Conversely, empopathy is a pathologically high and misdirected experience of empathy, leading to feelings of guilt, remorse, and misplaced responsibility run amok.

So how do you differentiate between appropriately empathizing with another and empopathy? For me, truly empathizing with someone requires us to fully see and hear them. We try and understand their experience from their own perspective, and, as Brene Brown puts it, “connect with something in ourselves that knows that feeling.”

Unfortunately that’s also where empathy can go off-course. Connecting with our own experiences and emotions is the gateway to empathizing with another, but it can also lead us down the wrong path since the person whose experiences we’re trying to understand happens to be not-us.

If you tell me that your relationship just ended and I respond with “I get it, I know it’s hard to feel unlovable and ugly and worthless,” you might feel understood and relieved that someone else is putting into words what you’ve been feeling. You might also feel taken-aback and disconnected if your experience was more along the lines of “she wasn’t really right for me.”

Empathy can also turn into empopathy when we project too much of ourselves into the other’s experience in another way, when what we’re empathizing with is not the other person’s pain but our own distress at feeling that we’ve had a hand in causing their pain.

A number of years ago, a man I was working with described a relationship break up he’d gone through. He said, “I went over to her place to tell her I wanted to end things. She cried, so 2 years later I left.” While he was no doubt empathizing with his girlfriend’s distress at the prospect of breaking up, his strongest connection in that moment was to his own feelings about being the source of that distress. Ultimately, it was empathizing with that feeling he found too much to bear.

Getting a grip

A couple of months ago I was sitting in the movie theatre with my 15 year-old daughter, weeping my way through Still Alice, the movie she’d urged me to see with her.

Unlike my daughter, I hadn’t read the novel the movie is based on but I knew enough of the plot – a woman’s descent into early-onset Alzheimer’s – to come with tissues prepared.

I was right to be prepared, it’s a gut-wrenching tale. Much of the movie centres on Alice’s relationship with her family (and especially her youngest daughter), as they all try to come to terms with her aggressive illness.

I sat sniffling in the dark, completely caught up in the story unfolding on the screen. I wasn’t just watching Julianne Moore playing a character from a novel, I was imagining myself learning that Alzheimer’s would make me lose myself a little at a time (and remembering that time I put the mail in the freezer, wondering if that’s a sign!)

I didn’t just see the complex mother and daughter relationship depicted on the screen, I connected to my own relationship with my daughter, how much she means to me and how quickly the years pass…

Said daughter, having endured enough vicarious embarrassment, broke into my reverie by leaning over and whispering, “Get a hold of yourself!”

Perhaps not the most empathic intervention one could offer, but it did shake me out of my painful pondering.

Although I try to put it more gently, I realize it’s the same advice I often give to clients when they’re caught up in anxious ruminating: “Get a hold of yourself, stay present with what’s happening right here right now, notice the stories playing out in your mind, and also notice that they are just that – stories.”

That isn’t to say that sad and terrible things haven’t happened or won’t happen, it’s just to acknowledge that our memory of something tragic or our projection of something feared is different from our lived experience in this moment.

Our minds are endlessly creative and uniquely skilled at spinning tales that will entertain, enliven, or terrify us. Anxious minds usually opt for terrifying. To paraphrase a famous quote by Mark Twain, some of the worst things that ever happened to us never happened to us.

If we can get emotionally caught up in a tale developing in front of us in a darkened movie theatre when we know it is all make-believe, it’s no surprise that the tale is that much stickier when it’s playing in an endless loop in our own heads, and stars us and the things we care most about and are most afraid of losing.

We might choose to distract ourselves from the stories, or land on rituals or superstitions that give us the illusion of control (knock on wood).

We can also choose to practice mindfulness. To get a hold of ourselves – sometimes literally – bring awareness to what is happening right here right now, to notice the movie playing and also notice that in this moment we are in the theatre seat, not in the scene on the screen.

Getting To Know You…

How do you make The Amazing Race even more amazing? If you’re after my own reality-TV loving heart, you incorporate elements of one of my other guilty viewing pleasures, The Bachelor.

And that’s exactly what the powers that be have done in this latest (26th!) running of the race. The race has always featured teams composed of 2 people who have some sort of relationship (parent-child, siblings, best friends, dating or married, etc.) but for this edition the teams consist of 6 established dating couples and 5 couples the producers have matched up.

The match-made couples meet each other for the first time at the beginning of the “race around the world” with the expectation that they will: get to know each other, explore the possibility of a romantic match, and work as teammates to complete what are often strange, arduous and stressful tasks. Did I mention they do all this while racing to various locations around the world, dealing with jet lag, the pressure of being under the watch of the ever-present cameras, and the stress of competing against the other teams for a million dollar prize? If they could work in abandoning the couples on a remote island and letting them fend for themselves it would be the perfect TV show!

I’ve only had a chance to see the first episode so far, but the thing that stuck out for me was the performance of the new vs. established couples. Since there is a race in the Amazing Race, the object is to get to the end of each leg of the race as soon as possible, with a prize waiting for the team that gets there first and the threat of elimination for the team that gets there last.

Out of the 11 teams, the 5 newly formed couples finished the first leg in the 1st, 2nd, 3rd, 6th and 8th spots. That’s a pretty impressive showing considering the things that one assumes would lead to better teamwork – mutual trust, established patterns of communication, knowing each other’s strengths and weaknesses – would seem to give the advantage to the pre-existing couples.

Except the pre-existing couples aren’t used to racing together, they’re used to negotiating a relationship together (perhaps its own kind of race). Research shows that the longer we’re with our partner, the more confident we become in the belief that we fully know our partner. We don’t become any more accurate in predicting our partner’s thoughts and feelings (if anything, people become less accurate), but our sense of surety in our own accuracy solidifies over time.

Why would that be? When we’re first getting to know someone, we are both taken with and unsettled by their ‘new’ness. We are curious to find out all we can about them, but also seek to file them away in our mental database, so we can feel confident we know what kind of person they are. Once we decide we’ve ‘solved’ them, we become less curious and less observant; confirmation bias starts to kick in and we see the aspects of their behaviour that confirm our beliefs, while ignoring anything that would seem to contradict them.

I feel that I can see that process starting to happen with the new couples. Immediately upon meeting each other, they start to use labels – “cute” “built” “friendly” – that are descriptive of overt characteristics or behaviour, but soon also start using labels (like “sporty” “bubbly” “smart” “princess”), that combine aspects of current behaviour with assumptions about character and predictions about potential future behaviour.

It will be interesting to see how it all unfolds, and how the match-made couples’ first impressions morph into more solidified beliefs about who their partner is. My guess is that their second impressions may not be any more accurate than their first, but they will be a lot harder to shake.