Author: Lee Kotsalis Thulin

I am a therapist in Private Practice in Vancouver, BC. I help people seeking to increase their capacity for connection to self and others address the issues that get in the way of that desire.

What Are You Laughing At?

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First the Seahawks stumbled and now Jon Stewart’s retiring — it’s been a rough couple of weeks in our household!

Jon Stewart’s announcement that he plans to step away from The Daily Show at the end of the year brought to mind a time in my life when his particular brand of humour greatly helped my own mental (and marital) health.

A number of years ago my husband and I had undertaken a renovation of the home we lived in at the time, a 110 year-old former crack house with good ‘bones’. We started with the top floor and for the duration of the renovation our bed was relocated to the basement. Our new room was a dark and kind of dreary place we affectionately called the Cave, but it did have one redeeming feature our old bedroom had lacked: a TV.

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Cartoon by Victor Yalom; permission to reprint by Psychotherapy.net

Now some people may tell you that planning and living through extensive renovations with your spouse will bring the two of you closer together. Step away from those people, they are cruelly lying to you. Like a bucking bronco, the renovation flung off any time and budget lassos we threw to try to contain it, and trampled over our initial enthusiasm and any lingering goodwill in the process. By the time the planned 6-week renovation entered its 3rd month with no end in sight, our patience – for noise, for drywall dust, for cost overruns, for sub-contractors and often for each other – was stretched to the limit.

We got into the habit of crawling into our cave bed at the end of the day and turning on the Daily Show. Jon Stewart’s ability to reliably find the humour (or at least the sardonic wit) in a situation helped us end the day in a calmer and more light-hearted frame of mind, and gave us a point of connection with each other (which would last. Right until the beginning of the next day!)

Donald Winnicott, a psychotherapist whose work was groundbreaking in the area of attachment, was asked by one of his students how he knew when a client he was seeing was someone he would not be able to help. He responded, “When I’ve sat with him for a time and there has been not a single moment of humour or levity.”

Having the ability to find humour, to see and laugh at our own human ridiculousness or the ridiculousness in a situation, is one of the most healing and therapeutic things we can experience. Although a typical therapy session might contain moments of heartfelt anguish and connection to grief or other emotional pain, when it also holds some laughter (as it almost always does), I know we’re on the right track.

Becoming an emotional “Weeble”

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Are you old enough to remember Weebles?

They were (apparently still are?) egg-shaped figurines with a weighted bottom, sold as toys to little kids who … like to play with egg-shaped figurines, I suppose. I never actually owned a Weeble, but their tagline has been indelibly etched in my brain: Weebles wobble but they don’t fall down.

I think there is a lot of value in being an emotional Weeble, regularly wobbling as you experience the highs and lows at the extremes of the emotional continuum (and everything in between), all the while trusting you will not fall down.

When it comes to experiencing strong emotions, too often the people I meet in therapy fear they will fall down, or worse, feel they have previously repeatedly fallen down and now live in dread of the next time it will happen.

One of the hypothesis to explain the development of panic disorder is to view it as a “fear of fear”:  the noxiousness of a previous experience of panic leaves us hypervigilant and sensitized to any changes in our body that might indicate another one is around the corner. This level of vigilance itself leads to symptoms in the body (since it activates the fight or flight response), which we then notice and attribute catastrophic meaning to. Catastrophizing thoughts create more fear, which exacerbates our physical symptoms, and the cycle continues.

Similarly, some of my clients with a history of depression are understandably highly attuned to their emotional fluctuations and notice subtle changes in their mood state. Developing a level of self-awareness and attunement to the early warning signs of depression is actually an important part of relapse prevention, but it can also be counterproductive when the emphasis gets narrowed to the moment-by-moment ‘how am I feeling’ rather than the broader ‘how am I doing’.

Depression is a pervasive mood state that impacts all aspects of our experience (our thoughts, emotions, and behaviour), while sadness or grieving are feeling states. Feeling sad about a saddening event is not likely to lead to a relapse into depression, but interpreting that sadness as a sign of an impending return to depression – and acting listless, resigned and despairing in response, avoiding work and social interactions, letting nutrition, sleep and exercise lapse – certainly could.

Being an emotional Weeble means being both willing to experience our emotions, and able to see that they are passing feeling states. Just like the Weeble that one might imagine screaming as it teeters to its edge, having a solid and grounded centre helps us pull back upright. And just like the Weeble, we likely won’t stay upright for long before the next wobble sends us teetering.

Into (and out of) the Inferno

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Dante’s Inferno is the inspiration for this post, specifically this description of his 5th Circle of Hell:

The river Styx runs through this level of Hell, and in it are punished the wrathful and the gloomy. The former are forever lashing out at each other in anger, furious and naked, tearing each other piecemeal with their teeth. The latter are gurgling in the black mud, slothful and sullen, withdrawn from the world.

Reading it made me wonder whether Dante had teenagers.

Long before I became the mother of a teenager, I had the opportunity to work with teens and their parents in therapy. I thought those experiences would inoculate me from turning into one of Dante’s wrathful when confronted with the slothful and sullen teen who’d replaced my daughter. I was wrong.

As a therapist sitting with teen clients, it’s easy for me to empathize with the challenges they face as they try to navigate the complex and multi-layered transitions involved in adolescence. The only other time in life that brain development undergoes as much change as it does during adolescence is in the period from birth to age 2. Along with changing brains, teens are also dealing with changing bodies, complicated peer relationships, as well as internal and external pressure and expectations. Since today’s teens are doing all of this under the intensified scrutiny that the virtual fishbowl provides, occasionally withdrawing into the black mud doesn’t seem like such a bad idea.

As a mother, parental wrath is also easy to understand. As one of my clients put it, “living with my son is like having the most demanding and least grateful house guest I’ve ever had, with no end in sight and no option to ask him to leave.” And what gem of a therapeutic intervention did I offer in response? I was all out of those so I instead tried asking her to insert a couple of words: at times. “At times living with my son is like having the most demanding and least grateful house guest I’ve ever had.”

Because the other thing the teenager’s brain has in common with the 2-year old’s is its inherent changeability. Week by week I watch my teen and young adult clients try different identities on for size, and experiment to find their own ‘right’ balance between individuation and connection. Like more life-seasoned clients, they work to discover who they are and decide who they choose to be, but teens’ turnaround time is much faster. They feel things more intensely, commit more convincingly, but are also able to release and move on more immediately.

While I’m not able to sidestep all the wrathful urges life with a teen throws my way, I try to keep in mind that – just like Dante – my visits to the 5th Circle of Hell will be a passage, not a life sentence. For Dante things arguably go from bad to worse (the 6th to 9th circles of Hell are no picnic either) but for most parents (and their teens) things dramatically improve.

To Tell the Truth

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Lately I’ve been immersed in binge-watching The Affair, a Showtime TV series about (you won’t be shocked to learn) an affair. As is often the case, this affair is between two people who are inconveniently married to others when they meet and become enraptured by each other.

There are a lot of subplots and interweaving stories that I won’t spoil, but one of the most interesting elements of the show is that each episode is divided into two parts, one weaving the narrative from the man’s perspective and the other from the woman’s. The most fascinating part of that for me is when the narratives intersect, and the viewer is shown the same part of the story from each of their two points of view.

Sometimes the differences in the perspectives are subtle. For example, in the depiction of how they meet and begin the affair the man paints the woman as a sultry and predatory femme fatale while remembering himself as a more passive victim of circumstance; in turn, the woman remembers him as the pursuer, and depicts herself more sympathetically. At other times their narratives are completely divergent so that the same elements (a farmhouse, a gun, an altercation) are spun into two vastly different scenes.

Wherein lies the truth?

When I’m working with couples, whether an affair is part of the narrative or not, disagreements about the ‘truth’ of an event are almost always present. Memory is a construction. Among other ingredients, the recipe for a memory includes images of the salient moments in an experience, our thoughts and feelings at the time, our expectations and predictions about what was said/not said, done/not done, the outcomes that resulted from the experience, and the cohesive story we’ve told ourselves about what happened.

By the time we are relaying that story to someone else, we are naming and experiencing it as the ‘truth,’ long losing sight of the fact that the other people inhabiting our memory will have their own truth.

I’m often caught by surprise when a client starts a sentence with “It’s like you said last week,” and follows that with something I have no recollection of saying (and sometimes no desire to claim as something I ever would have said!) Fortunately, in the context of therapy this is something we can explore, comparing what each of us thought was salient in forming our experience of the ‘truth’ and coming out of that conversation with (hopefully) a stronger sense of connection and mutual understanding.

Outside the context of therapy, finding that someone else remembers the truth differently than we do usually leads to an argument. We fight about whose truth is truer, try to persuade the other to remember it our way, and each consequently become more entrenched in the rightness of our own point of view.

We now have the ability to memorialize events in a way we never would have 20 years ago. We have conversations over text rather than in person or by phone, and most of us carry devices that double as cameras, voice and video recorders on our person at all times.

Perhaps we will soon outpace the need for constructed memory, but I fear that focusing on the content – being able to definitively answer the question of what was said and done and by whom – will take away from the process: acknowledging that we all have our own perspectives and therefore our own claim to the ‘truth’.

What’s New this New Year?

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I love this time of year, especially the ritual of ushering in a New Year. With its promise that we can wipe the old slate clean, and write a better story on a new, refreshingly (as yet) unsullied one, what’s not to love!

What will your ‘better’ story be this year?

At a meditation a few years ago the teacher spoke of how “sometimes we are eyes without feet, sometimes we are feet without eyes.” We can have a clear and defined vision of what we want but take no steps to get there, or we can take a lot of steps in various directions – be in constant motion in fact – without any sense of where exactly it is we’re going.

The tricky part is connecting eyes and feet, not only identifying what we want, but also taking meaningful and sustained action to get there.

For many of the clients I work with, the meaningful action required paradoxically has less to do with motion and more to do with finding a willingness to be still.

When anxiety is the issue, motion is generally not a problem. We go to great lengths to escape anxiety, or at least attempt to keep it at bay. We may turn down invitations to socialize, engage in rituals that give us a sense of control in an uncontrollable world, or opt to avoid any people, places and things that make us feel uneasy. All of these ‘feet’ align with the ‘eyes’ of easing our discomfort, but if our vision is actually to have a bigger, more engaged, and more engaging life these footsteps will not get us there.

The step we need to take to move in that direction is to increase our capacity to sit with and bear the feeling of anxiety that comes when we are stretching our comfort zone, testing our limits and beliefs. Seeing that the experience of anxiety, while undeniably uncomfortable is not intolerable, is a key step to breaking the hold it has on our lives (and our feet).

Letting it go

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The first time I heard Frozen‘s Elsa belt out the now ubiquitous “Let it Go” song, I thought it had a familiar ring. That’s because when I ask clients how they think therapy could be helpful to them, “I want to learn how to let it go” is a common response.

The ‘it’ can be a distinct trauma we’ve survived, or the soul-crushing never-ending hum of anxiety. It can be loathing or criticism we heap upon ourselves, a hurt someone else has inflicted, or some other painful emotional pressure. Whatever it is, we all want to learn how to let it go.

By the time difficulty with letting it go has announced itself as a problem, we’ve tried many different ways to get it gone. We’ve drunk (or drugged, or fed, or TV-viewed, or worked, or exercised, or sexed, or slept) ourselves into oblivion, we’ve taken Elsa’s approach and tried to ignore and conceal what we’re struggling with, we’ve started new relationships to get over the hurt of old ones. And yet ‘it’ stubbornly remains, outwaiting and outlasting our efforts to make it go away.

The paradox of letting it go is that we first have to let it come. We have to let ourselves identify and experience what we’re feeling, and accept it. Tory Brach, author of “Radical Acceptance: Embracing Your Life With the Heart of a Buddha” defines radical acceptance as having two elements, “an honest acknowledgment of what is going on inside you, and a courageous willingness to be with life in the present moment, just as it is.” Radically accepting something doesn’t mean condoning it, liking it, or resigning yourself to having it always be so, it simply means becoming more willing to experience all that is present for you in this moment without judging it, resisting it, or pulling away from it. It means noticing your desire to judge, resist, and pull away, and radically accepting that as well.

Carl Jung said that “What you resist, persists” while Buddhist Shinzen Young chose to articulate the issue using a mathematical formula: Suffering = Pain + Resistance. We cannot influence our experience of pain – what has happened has already happened – but by learning how to bring more acceptance to the experience we can save ourselves some suffering.

Worrying Well

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There is no doubt we’re living in worrisome times, and little doubt that past generations would have said the same of their times. If worry is ever-present, learning how to worry well (or at least better) seems a useful skill to master.

How do you worry? Are you someone who replays past conversations or events over and over again, going through in detail what you said/should have said, did/should have done? Or is your worry more focused on the future, anticipating how something will unfold, what you’ll say next time your mother gives you that look, or you see that cute guy or girl?

Worry is essentially our brain’s tendency to rehash and rehearse – it replays the past hoping we will learn from our mistakes and therefore not repeat them, or anticipates the future, giving us a chance to run our lines and prepare our scripts.

But while these are helpful and necessary processes, worry can also become chronic. It can keep us so caught up in rehashing the past or rehearsing the future that we fail to be present to the present.

If you find that worry sometimes has its way with you, here are a couple of things to try:

  • Take a worry inventory: using post-in notes or some scrap paper, take a walk through your mind and identify the things that are currently asking for your worried attention. As you find these – for example, “there’s the thing with my sister, remembering to book my flight for next month, talking to my boss about the project”… – write each one on a separate piece of paper. If there are any items that you need to deal with right away, pull them aside and organize them in the order you will address them. If none of them are pressing right at this minute (Hint: if it’s 2:00am and “get out of my burning home” is not one of the items, NONE of them are pressing right at this minute!), put them in a box or jar and lay them aside until you are able and willing to address them. You will likely find that just the act of acknowledging the things that are preoccupying you, and giving yourself the message that you WILL deal with them is itself freeing.
  • Try the ‘worry well but only once’ technique proposed by Margaret Wehrenberg. Set aside a time in your schedule (20-30 minutes) and make that your worry time. Use that time to actively worry – rehash and rehearse to your heart’s (and mind’s) content, make the lists you need to make, plan the strategies you need to plan, review the foibles, humiliations and disappointments you need to review… Then when your time is up, put worry away. If it calls your name later on, remind yourself that you already worried today and you’re going to worry again tomorrow, so save it for your worry time. You may find that condensing worry into an acute 20-30 minute time slot is much preferable to the 24/7 chronic low-grade variety of worrying.

Taming Your Saboteurs

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Have you met your saboteurs? I’m not talking about the spouse who brings home your favourite dessert to celebrate your sticking to a meal plan, or the friend who compliments your weight training achievements with “you’re really getting cut – does it bother you that people will start to think you look like a man?”

The saboteurs I’m thinking of live even closer to home, in your own psyche. They sometimes act up just when things start going your way, and sometimes wait until you’re getting close to reaching a goal you’ve been striving for before they pounce.

When I’m working with someone and find that they have either hit a prolonged plateau or are backsliding after some initial progress, one of the things I’m always curious about is whether there’s a saboteur at work. Because while process resistance may often rear its head –knowing what to do in order to get what we want, but not always wanting or feeling motivated to do it – sometimes the saboteur is outcome resistance. Outcome resistance is the part of us that wants what we want but also fears what we want, or is uncertain we can handle all that comes with what we want, or wonders if we should want what we want, or gets stymied at the thought of what we’ll want next, etc. etc.

Outcome resistance usually operates at the preconscious level, because it’s linked to our core beliefs – that is, our long-ago formed ideas about who we are, how the world works, and what we deserve. If someone has a deep-held belief that they are undeserving (of love, of health, of attention from others for example), the glaring incongruity between that belief and the changes they are trying to make creates the space for sabotage; to bring things back into alignment, they would either have to change their core beliefs (if the ‘core’ didn’t already tip you off, this is not an uncomplicated task), or bring their outcomes closer in line with their beliefs.

So how do you prevent your psychic saboteurs from, well, sabotaging? You start by being really clear on why you want what you want. For example: Why do I want to change my eating habits? Not (just) because I want to fit into the too-small jeans I bought on sale last week, but because I deserve to live in a body that is mobile and has energy and vitality; I want to feed that body well, and move it every day.

So next time you’re contemplating making a change that you think will significantly impact your life, spend at least as much time thinking about why you want to make that change as you do thinking about how you’ll go about it. Getting familiar with where your potential saboteurs may be waiting for you is the first step to negotiating your way around them.

To Forgive – Divine!

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Since my last post was about the art of the genuine apology, it seems fitting to spend some time on its counterpart: forgiveness.

In her book How Can I Forgive You?: The Courage to Forgive, the Freedom Not To, Dr. Janis Abrahms Spring describes 4 approaches to forgiveness, and notes that they are not created equal. The four are: Cheap Forgiveness, Refusing to Forgive, Acceptance, and Genuine Forgiveness.

Cheap forgiveness is what Dr. Spring calls “a quick and easy pardon.” It is premature, superficial and undeserved, and usually happens when the person who has been hurt has a hard time tolerating the distress that acknowledging the hurt would create (in themselves or in the relationship), and seeks instead to smooth things over as quickly as possible. Cheap forgivers are sometimes prone to conflict avoidance or have a self-sacrificing approach to relationships, and struggle to set healthy limits or speak up for themselves. The harm of cheap forgiveness is that paving over or denying a hurt doesn’t actually do much to heal it, and the fall-out from those unhealed hurts has a way of leaking out and poisoning a relationship.

At the oppoSpear_2278site end of the continuum, those who refuse to forgive resist letting the offender off the hook, even after a sincere apology has been made. They respond with distance and condescension, and use hoarded past offences to build a wall fortified with righteous indignation. If engaging in relationship is always a balance between connection and protection, non-forgivers plant their feet firmly in protection, and cost themselves the closeness and repair that forgiving a sincere apology could offer.

But what if no apology (sincere or otherwise) has been made? What if the offender refuses to acknowledge that their actions were hurtful, or worse is dismissive and devaluing of the feelings of the one they’ve hurt? Acceptance is a form of forgiveness whose purpose is to help the hurt party help themselves. It allows the hurt party to acknowledge and take control of their pain, work to heal from the harm they’ve experienced, and decide the level of relationship (if any) they want to have with the offender.

Dr. Spring’s book details the process of genuine forgiveness, calling it a “shared venture where two people exchange their care, compassion, understanding, and empathy with each other.” Accordingly, earning genuine forgiveness requires the offender to apologize (genuinely, non-defensively and responsibly), bear witness to the pain they caused (showing their partner they can empathize with how the transgression made their partner feel), and work to earn back trust.

So when genuine forgiveness has been earned, what does it look like to give it? Genuinely forgiving means allowing our relationship to move forward. It means acknowledging that we’ve heard the apology and believe its sincerity, giving our partner a chance to earn back trust, and committing to not bringing up the past hurt the next time we feel scared or angry.

(Cartoon by Kevin Spear, Creative Commons License)

Sorry Seems To Be The Hardest Word

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What is it about apologies? What is it about the thought of saying “I’m sorry” that puts in motion that hardening, closing, resisting feeling in the pit of our stomachs, that corrals our minds and constricts our throats (or maybe that’s just me)?

Early on in the relationship with my husband my apologies used to sound something like this: “Am I sorry? Oh, I’m sorry. Sooo unbelievably sorry that you are too immature and too oblivious to even try and wrap your tiny little brain around what I was saying to you. I apologize.” Charming, no? Defensive apologies take the semblance of an apology, wrap it in an attack, and deliver it like a brick through a window. They are about as helpful at repairing a relational hurt as having a double espresso is helpful at calming your nerves. That’s not to say they don’t serve a purpose, it’s just a very different purpose than the one apologies are intended to serve. Defensive apologies soothe our own egos, let us stay in the protected (but disconnected) place of “I’m right and you’re wrong” and create distance in a relationship when closeness may feel too vulnerable to bear.

Shame based apologies on the other hand, look more like a genuine apology on the surface: “I did it again didn’t I? God I’m so sorry, I don’t know why you put up with me. I am such a piece of shit, I hate myself.” A shame based apology changes the conversation. Your partner is no longer talking about whatever it was they were upset about, they’re refuting (or agreeing with) your basis for self-loathing and end up either putting their own concerns aside in order to comfort you, or feeling like a monster for kicking you when you’re already kicking yourself.

So what does a genuine apology sound like? It starts with “I’m sorry.” Not “I’m sorry but” followed by excuses, rationalizations or explanations, not “I’m sorry you feel that way” or “I’m sorry if I did anything to hurt you.” In short, a genuine apology starts with genuinely feeling apologetic, honestly assessing your side of the interaction and taking ownership of your part in it. The second part of a genuine apology is talking about the experience in a way that shows your partner you can empathize with their point of view. For example, “I’m sorry. What I said was mean and hurtful and probably made you feel like you don’t really matter to me.” Your ego will not enjoy your genuine apology (alright, I’m talking about myself again), but your relationship definitely will.