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Summer Reading List for Recovery

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School is winding down, vacations from work are beginning, and all the down time can wreak havoc on recovery. If you are in need of some motivation to stay on your recovery path, bring these books along on your summer journeys and find some inspiration!
Good Eating Disorder Books!
  • Life Without ED~~ Jenni Schaefer
  • Reclaiming Yourself from Binge Eating~~ Leora Fulvio
  • Your Are Not Alone~~ Shannon Cutts and Andrea Roe
  • Chasing Silhouettes~~ Emily T. Wierenga
  • Goodbye ED, Hello Me: Recover from Your Eating Disorder and Fall in Love with Life~~ Jenni Schaefer
  • Mom in the Mirror: Body Image, Beauty, and Life After Pregnancy~~ Dena Cabrera, PsyD and Emily T. Wierenga
  • Shattered Image~~ Brian Cuban
  • Midlife Eating Disorders: Your Journey to Recovery~~ Cynthia M. Bulik, PhD
  • Your Dieting Daughter~~ Carolyn Costin, MFT, Med, FAED, CEDS

Treating the Family System

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When an eating disorder strikes an individual, his or her entire family is affected. According to an article by Abigail Natenshon, MA, LCSW, GCFP, 87% of eating disorder patients are children and adolescents under the age of 20. As many in this age group still live at home, the eating disorder develops and plays out within the family dynamic. It often takes on a life of its own and can be the cause of many battles at meal times, family gatherings, holiday events, and can even affect extended family and school environments. Family therapy is an essential part of eating disorder treatment and is necessary to ensure everyone who is a part of the family system is cared for.

The Family System Theory

Developed by Dr. Murray Bowen, family systems theory posits that the family is a unit and the emotional connections fostered by thoughts, feelings, and actions create an interdependent environment. This interconnectedness helps the family to become cohesive and supportive of its members. If there is unrest and tension, emotional connections can become more stressful. If there is a member of the family who tends to take on the emotions of the other members and may take on an accommodating role, leading to overwhelm and isolation. This is the family member who may become more susceptible to addictions, depression, anxiety, eating disorders, and illness.

There are eight concepts to the family systems theory:

  • Triangles: A three-person relationship system
  • Differentiation of self: Variation in how people are susceptible to pressures to conform to the group
  • Nuclear family emotional system: Four basic relationship patterns (marital conflict, dysfunction in one spouse, impairment of children, emotional distance)
  • Family projection process: The way parents transmit their emotional issues to children
  • Multigenerational transmission: Differences in differentiation across generations
  • Emotional cutoff: Managing emotional issues by cutting off family members
  • Sibling position: Impact of sibling position on behavior and development
  • Societal emotional process: Emotional systems govern behavior on the societal level

Family systems theory can be used to help clinicians understand the dynamics of the family presenting to work through one member’s eating disorder.

Family Involvement in Eating Disorder Treatment

Comprehensive treatment plans at all levels of care will involve family therapy. Center for Discovery residential programs involve the family weekly in a therapeutic way, not only in family therapy but also at meal times by facilitating therapeutic family meals. The purpose of these activities is to observe family dynamics at meal times and in social situations in order to best prepare the family for realignment and a return to balanced interconnectedness.
Some clients benefit from a type of family therapy called Family Based Therapy (FBT, also known as Maudsley). This outpatient approach, which places the refeeding process in the hands of the parents and moves the family through phases of treatment as recovery develops, has proven to be very successful for adolescents with anorexia.

In outpatient settings, family therapy is usually recommended in conjunction with individual therapy, nutrition services, and group work. As the eating disordered member reintegrates back to the system after being away at treatment, therapy is needed to help the family adjust once again. An eating disorder has the potential to isolate family members from one another, create discord in the system, and indeed can be either sustained or eliminated depending on the dynamics of the family system. It is important for clinicians and parents to know that parents do not cause eating disorders. The entire system needs attention and support to thrive again.

Natenshon, A. Family Treatment is Cornerstone of Effective Care for Eating Disordered Children. Treating Eating Disorders, www.abigailnatenshon.com

The Bowen Center for the Study of the Family. www.thebowencenter.org

Contemplating Change: Moving Beyond an Eating Disorder

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Recovery from an eating disorder requires an incredibly courageous step into the unknown. It requires relinquishing control and moving through the stages of change to reach acceptance and health. This is easier said than done and takes time. One of the first steps is identifying what purpose the eating disorder serves and therefore what emotional needs it is meeting. Only then can the person begin to find healthy ways to meet those needs and heal.

What is the Function?

Very often, people with eating disorders find themselves in life circumstances that leave them feeling like they’ve lost control. Maybe there’s been trauma or a loss, or maybe bullying at school or a lack of identity. The eating disorder swoops in at these vulnerable times, offering a lifeline in the form of a sense of power and control, a numbing of painful emotions, something to feel accomplished about….a savior that ends up creating devastation and life-threatening complications.

Stages of Change

Moving beyond resistance and denial to contemplation and action feels impossible when the eating disorder is in full swing. Many people arrive at treatment at the urging of family and friends without the slightest idea themselves of why they are there. The stages of change put a timeline to this process, and it is possible to envision when one might arrive at identifying and challenging the purpose the eating disorder serves.

Precontemplation: People in this stage tend to be resistant to change. They are in treatment for others. They feel hopeless.

Contemplation: Recognizes there’s a problem (and perhaps now is aware of the purpose the eating disorder serves) and begins to anticipate an imminent change.

Preparation: People sometimes experience ambivalence in this stage as they prepare for change but still aren’t 100% convinced it’s a good idea.

Action: Time and energy are committed. Behaviors begin to change.

Maintenance: Continued action is required to maintain recovery. It is a fluid process with frequent adjustments.

Letting Go

A person in the throes of an eating disorder truly believes that the illness brings value to their life. It likely has shown merit at some point, in the form of the purpose it serves in the person’s life. For example, someone who has experienced life in an alcoholic home may now feel in control for once….amid all that chaos, the eating disorder created a way for the person to feel competent, in control, and superior. In this case, the eating disorder creates control where there was chaos and a false sense of self-esteem where there was self-hate and uncertainty. It becomes difficult to build a case against the eating disorder when it has brought some semblance of order to the person’s life. Recovery begins when the person recognizes the purpose served and can accept that what once felt like control has now become out of control and not sustainable. An article by Emily Troscianko (2010) poignantly states: “Somewhere along this road….You may come to see that exerting control is simply no longer what’s required of you.” Letting go catalyzes action, and action leads to recovery.

Troscianko, E. (2010). Why Control Won’t Bring You Happiness. Psychology Today, www.psychologytoday.com

Spirituality and Recovery: Rediscovering Meaning in Chaos

Eating disorders represent a crisis of some kind, be it trauma, low self-esteem, poor body image, bullying….clients present with many different root causes of their disorder. The one underlying theme is distraction and coping. The eating disorder serves as a best friend, a confidant, a powerful secret, and appears at the time the client needs it most. In a storm of chaos and fear and inconsistency, the eating disorder swoops in and rescues the client temporarily from the distress.

Michelle Lelwica (2010) shares that while the client is focused on creating a “good” body or engaging in eating disorder behaviors like restricting or purging, the inner life is being ignored. No matter how thin the client gets, no matter how filling the binge, there is an eternal sense of emptiness and hunger that is never satisfied. All of the crises that pile up in life, all of the hurts and trauma, drive a wedge through the true self. Big questions like “What is important in my life” and “How do I understand my life’s purpose” cannot be answered when the soul is entrenched in an eating disorder. There is simply no energy left for living. Recovery becomes a spiritual journey as clients attempt to access their pain and face it with the help of a higher power.

Randy Hardman and Michael Berrett (2015) explain that many people with an eating disorder have had some degree of personal spirituality in their lives. Some have participated in religious observations and others may have felt connected to yoga or nature or a meditation practice. Despite this, during the course of the eating disorder these connections were lost. Feelings of unworthiness creep in as the eating disorder, which at one point served a purpose, becomes harder and harder to sustain. Indeed, eating disorders cause sufferers to chase false pursuits that ultimately replace spiritual connection. Hardman and Berrett list these false pursuits:

  • False sense of control
  • False form of communication about pain and suffering
  • False sense of being the exception or exceptional
  • False crusade for evidence against self
  • False pursuit of perfection
  • False form of comfort and safety
  • False identity
  • False compensation for the past
  • False attempt to avoid personal responsibility
  • False pursuit of approval

Eating disorders may represent some or all of these falsehoods for clients. Richards et al (1997) state that eating disorder clients often have difficulty letting go and having faith, despite their spiritual background, leading to a worship of these falsehoods in pursuit of a sense of control and well-being. Along the way the eating disorder gains control of every aspect of their lives, rendering clients powerless when all they were seeking all along was a powerful sense of being good enough.

Not all clinicians work with spirituality in treatment with their clients, but it is a significant aspect of recovery that can’t be avoided. Clients who wish to regain their spiritual connections, or foster connections for the very first time, can do so in the safety of the therapeutic alliance. Eating disorders are very hard to give up because it is difficult to remember what life was like beforehand and next to impossible to consider what life might be like in recovery. There is so much unknown and that is often one of the biggest barriers to recovery. Spiritual exploration during treatment can help clients resolve any negative impacts their spiritual pursuits had in the past and move forward with new resolve to take care of their physical, emotional, and spiritual selves.

Lelwica, M. (2010). The Spiritual Dimensions of Recovering from an Eating Disorder. Psychology Today, www.psychologytoday.com

Hardman, R. and Berrett, M. (2015). Eating Disorder Recovery: A Spiritual Perspective. BYU Idaho Counseling Center, www.byui.edu

Richards, P., Hardman, R., Frost, H., Berrett, M., Clark-Sly, J., and Anderson, D.
Spiritual issues and interventions in the treatment of patients with eating disorders. Eating Disorders: Journal of Treatment and Prevention, 5(4), pp. 261-279

Self-Compassion: Paving the Road to Recovery

 

I have been fortunate enough to experience eating disorder recovery from two perspectives: personal and professional. It has been a joy to emerge from the dark depths of anorexia to discover a life full of purpose laid out before me. Similarly, it is inspiring to witness clients gain insight and move toward health and well-being. In both capacities I have learned the importance of self-compassion as a foundation for lasting recovery.

Learning to Love Yourself

A common theme I’ve found threaded through many eating disorder cases is a lack of self-esteem and self-compassion. Some individuals have exhibited a great ability to be compassionate and empathetic towards others, but are unable to give themselves the same respect. More than a few times I’ve heard “They deserve compassion and respect, I don’t.” When pressed as to why this is, most can’t give a concrete answer. It seems to be a deep self-loathing for reasons mostly unknown.

The problem is that when we lack self-esteem and self-compassion, we look externally to receive them. We may think that if we excel in school or work, if we are popular, if we are thin and attractive, we will feel like enough. Over time we discover that even if we achieve all of these things, there is still something missing. That emptiness feels like “I’m still not good enough,” and so we cling to the eating disorder for reassurance that at least we are good at something.

Of course, there are many complex reasons why eating disorders develop and it can take a long time to really unravel the root causes. But the bottom line is that for lasting recovery, we must be willing to sit with and learn to accept ourselves as the amazing, perfectly imperfect humans that we are.

Ten Steps to Self-Compassion

Recovery is an investment in yourself. It is a decision to put yourself as a priority and learn to accept the person you are. There are many ways to accomplish this, but here are ten steps that can lead to self-compassion:

• Practice compassion! That’s right, resolve right now to speak to yourself gently. Give yourself some grace.
• Invest in recovery. This means engaging your treatment team as recommended, doing your homework, and being accountable for your journey to wellness.
• Take your medications as prescribed and follow your meal plan. Learn what it feels like to have your body’s needs met, and learn to cherish that feeling of wellness.
• Practice mindfulness. Learn to enjoy each moment as it comes.
• Recognize and honor your feelings. Make space for them and allow yourself to experience and express them.
• Cultivate your interests and hobbies. Make time for the things you love to do and that bring you joy.
• Practice positive self-talk. Work with your therapist to develop skills to challenge your negative thoughts and replace them with positive.
• Develop a new relationship with your body, one built on acceptance and respect.
• Know your triggers and have a plan to mitigate them.
• Work to accept yourself, your genetics, your mistakes, your achievements, and all of the wonderful, unique things that make you the only you on this planet.

 

Need further guidance to practice self-compassion and start your journey to recovery? www.prosperityedwell.com

Carolyn Labrie, PhD(c)

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Carolyn Labrie, PhD(c)

Carolyn Labrie, PhD(c)

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New Year and Small Steps

 

New Year’s Resolutions: Small Steps Toward Recovery

 

A new year brings a clean slate, a chance to forget about the struggles of the past year and make fresh choices for the future. It is common for people to make New Year’s resolutions, goals set to create positive change. In our society, New Year’s resolutions often focus on weight loss and exercise. Go to any gym in January and you will have difficulty accessing equipment because of the crowds. All this focus on appearance and diet can be triggering for people in recovery from an eating disorder. While weight loss goals may have been a focus in the past, in recovery it is no longer a viable option. How can we make healthy, recovery-focused New Year’s resolutions in a culture of excessive dieting and exercise?

 

Meet Yourself Where You Are

 

A new year is a great time to take an inventory of where we are and the things we want to change. It is important in this inventory to realize that where we are right now is exactly where we need to be. There is no need to come down on ourselves for falling short of goals or encountering setbacks. Take this opportunity to practice self-compassion and have patience with yourself. In this compassionate space you will be able to see the areas that need more attention and set goals for realistic progress.

 

One Day at a Time

 

According to an article on Eating Disorder Hope (2013), among the top 2013 New Year’s resolutions were “becoming more physically fit” and “losing weight.” For anyone with an eating disorder, these resolutions are dangerous. Engaging in behaviors that trigger the eating disorder voice can lead to a relapse. For anyone, these generalized resolutions sound great at the time but quickly feel overwhelming because there is no instruction manual attached to teach us HOW to get there.

 

The great thing about resolutions is that we are in charge of creating the instruction manual! Recovery is an active process and we place the guideposts with the help of a treatment team. If you are in recovery, your New Year’s resolution might be to practice self-care. You can work with your treatment team to set smaller goals to achieve this. Perhaps this will mean engaging in one self-care activity, however small, per day. Over time these positive actions add up to larger gains in the form of increased mood and self-compassion. Recovery is truly a daily endeavor and if we focus on the moment and use our skills, progress will be made.

 

Setting Resolve

 

This New Year, resolve to put your recovery first. Although you may feel uncomfortable and triggered by the appearance-focused resolutions around you, be firm in your conviction to be well. The choices you make about your recovery will influence the direction your journey takes. Remember that even the smallest positive steps will eventually bear fruit in the form of lasting health and happiness.

 

Wishing you a New Year full of discovery, joy, and wellness!

Eating Disorder Hope (2013). A New Year’s Resolution Worth Keeping. www.eatingdisorderhope.com

I think I can. I think I can. I think I can. Keys of Eating Disorder Recovery

I think I can. I think I can. I think I can. Keys of Eating Disorder Recovery

 

I have seen so many of my own patients with Eating Disorders (ED) struggle with how to move beyond the Stage of Change in recovery : “I know I have a problem but not willing to do anything about it ” and get to the Stage of Change: ” I know I have a problem and I am willing to do everything I can to get better”.

With my patients who tell me that they can’t get better, they won’t get better or they don’t even really have a problem, I have noticed a few things:

  1. GREY MATTERS: The majority of people that have the disease of an eating disorder think in absolutes. Black and White. I am either fat or thin. I have no control or I am in total control. I have to do everything perfectly or not at all. 
  2. They feel they can not survive life without their Eating Disorder. They believe that if they choose to start recovery they will lose all control, their voice, their protection, their identity and their purpose in life.
  3. They believe that if they do not have their ED they will no longer be successful, fulfilled, special and worthwhile.

So to be able to get to the next stage in recovery, one must believe:

  1. That they are capable of anything they put their mind to. Someone with an eating disorder is a very determined and capable person. Perseverance is key.
  2. Their ED has begun out of some form of unmet need. They need to learn to be able to fulfill their wants and needs out of assertiveness, determination, perseverance and creativity.
  3. They are capable of change. They are not made of stone, but of soft clay that they can continue to mold, sculpt and make into their best selves.

As a therapist, my role is to never give up on finding a way to communicate these truths, to motivate them to take risks and to take one baby step at a time.

I think of the “little engine” who despite it’s limitations, never gave up, believed in it itself and always had someone cheering him on.

Heather Baker, LCSW, CEDS

 

S / M / D / W – What’s your status?

 

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S / M / D / W – What’s your status?

In the age of internet dating and saturation of picture perfect images, it is easy to get swept away in a search for love. We tweeze, pluck, lift, slather, sweat, scrub, dress, and obsess all in a preparatory hope to meet The One. Perhaps we go on blind dates, fill out online inventories, suffer through coffee with the nice boy/girl our granny knows from church, or hit the bar/club scene when all we want to do is crash on the couch with a bottle of wine after a long week.  Amidst the ads for eHarmony, Match.com, etc. and the wedding planning industry, I can’t help but think about what all the buzz is about. Why is finding love (or at least the appearance of it) so important to us and to society? What are we really looking for; who are we looking for; how are we defining love; and where are we looking for it?

The way I see it, love takes many forms and that’s a wonderful thing, because it means we have access to a variety of loving sources that can feed our souls and comfort our hearts. One of the reasons I think the focus on our romantic status has become increasingly important is that we are searching for an external solution to an internal problem. In this search for love, we are often looking for validation, support, and acceptance from someone else. I’ll be the first to admit, this feels really, really, really good, it’s nice, really nice to hear that someone you care about values your opinion and cares.

The unfortunate reality is that sometimes this search for external validation, compounded by external pressures to meet The One or “make it work” we lose our power in the process. Maybe, we try to make the one we are with fit into the space we have created for the one, which feels about as good as a dress that’s two sizes too small. We’re cramming all our needs and expectations into a source that’s not built for it. When the search for the one takes too long or when we’ve kissed one too many frogs, we start to question ourselves. It’s disheartening. In searching for connection for the external validation, we can lose connection with ourselves. What am I doing wrong?! What’s wrong with me?! Why don’t they like me? I’ll never find love. We all know what that looks and feels like, when we sit on the couch with our bottle of wine and get so deep in our thoughts we could drown ourselves in a cup of water. Or maybe we are in a relationship, or recently lost one, and feeling hopeless and deflated. We forget the most important source of love, self-love. We forget that we can feed our own souls and comfort our own hearts. Often, instead of believing that we are enough, we self-damn and self-criticize and reinforce this society preference for a deficit based approach.

What if we turned that on its head? What if, instead of wallowing or questioning or assuming there is something wrong with us, we took that time to really get grounded in who we are and what we like. What if we started to pull from all the sources of love around us, and let that be enough? I am a true believer that like energy attracts like. If you are in a good place mentally, physically, spiritually then you are going to be well positioned to draw and attract that same kind of love from a partner (the residual benefit being that other relationships in our lives start to shift for the better). It’s less about what am I doing wrong and more about what am I doing to serve myself and the people I love. Where am I not taking care of myself the way I want someone else to take care of me?

If we listen to all the expectations of society, our family, friends, and that vision we had for what life was supposed to look like, then we end up missing out on living and loving the life we have. The relationship with ourselves is and will always be the most important relationship we have. Staying connected to our true self helps guide us to the path where we will be primed to love and be loved. The take away here is regardless of your status, start with your relationship with yourself.

Be Kind to Yourself. Be kind to Others. Keep it Moving.

When Perfection is Imperfect

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What is perfection? Current society would have us believe that it is the Stepford Standard, that anything less than keeping up with the Joneses makes us substandard, less relevant, not good enough, or just plain not enough. Webster’s defines perfection as “having all the required or desirable elements, qualities, or characteristics” and “completely free from faults or defects”. Maybe it’s just me but I feel like these definitions are in conflict.  Why can’t I have all the required or desirable elements, qualities and characteristics, AND still have faults? Why can’t I be perfectly imperfect? Perfection can be found in the faults, in the quirks that make us who we are and the experiences that we grow from that have been less than perfect.

Is it even possible for anyone or anything to be truly perfect (i.e., without flaws)? Rationally, I think most would agree that it’s not. Rationally, we know that it is part of the human experience to be flawed, to make mistakes, to rise from the proverbial ashes. But how can we rise if we’ve never been burned? Rather, in perfectionism we are consumed by the flames, the need for this unattainable perfect. Why is accepting imperfection so hard? Brene Brown has done an amazing job of addressing this question, in fact much of her work focuses this very topic.

The point of this post is not to delve into imperfection, but rather how we know when our need to be perfect, to be “completely free from faults or defects” is getting in the way of this thing called life. Society tells us that if we aren’t the highest performers, if our parties aren’t the biggest, the best, the ultimate event that has Gatsby in envy, then we aren’t doing it right.

How does this happen? How do we miss the point of the very thing we are trying to achieve? It’s simple, we forget to think about the intent of the goal itself. And, when we forget about the intent (the desired end state or outcome) we go into the perfectionistic planning mode. If you are prone to this mentality then you know how time consuming and crazed the planning gets around a desired goal. The flaw here is that the obsessive planning, the extensive preparation and painstaking compulsion to think about everything that should happen, everything that might happen, the need to think (aka obsess) about all of the knowns and unknowns, gets in the way of the goal. Not to mention it makes the process of reaching the goal exhausting. Essentially we run ourselves into the fire of worry about the “what if’s”, all the while missing the point of the event.

Take this for example, say you want to get friends together for a game night. The idea being that you would get folks together, maybe have some food, maybe some drinks, and everyone has a night full of commercial worthy fun. The perfectionist dives immediately into the planning and organizing of the “perfect” game night. Sending out the fancy semi-formal electronic invitations with the “perfect” play on words that “perfectly” captures the theme of the night. Then to the food, drinks, and venue prep. The perfectionist struggles with letting everyone bring a dish (what if two people bring the same thing, or some other catastrophe happens?!), people can bring a side but no matter what the “perfect” host needs to have the “perfect” culinary item that could make Martha Stewart green with envy. Everything must be organized, “perfectly”… heaven forbid the drink cooler not match the centerpiece. The games, must be selected with care, to facilitate the most fun of course. And then amidst all the planning and preparation for the “perfect” party, the home must be spotless. Above all cost’s this house must not look lived in!!! In the perfectionist frenzy, you stop thinking about the intent of game night, and start obsessing on the need for “perfect”, the rave reviews; you’re looking for the 5 star yelp review for what started as a means to connect with your friends/families.

Rather than connecting, you’re disconnecting. There’s no room for fun and friends when there’s a “perfect” party on the horizon. If you think your friends can’t feel the anxiety of your perfection obsession aura puts off, let me tell you, in no uncertain terms, they can. Your “perfect” planning is imperfect. It’s driven by an unattainable need to be “perfect”. Did you ever stop to wonder what perfect was?… in this case it’s not the best party favors, or the game selection, or the food, or the drinks. What makes game night perfect is the intent. You are creating a space for people that you know and love to come together and have fun (that’s the intent, that’s the desired outcome). It doesn’t matter if people love the food, or find a speck of dust under the coffee table, or if no body plays games at all on game night. What matters is that you brought people together for an evening of levity.

Some of the common cognitive distortions associated with perfectionism are:

  • Black-and-white thinking – “If this is not perfect, I am a failure.” Or “Only lazy people ask for help.”
  • Catastrophic thinking – “Everyone is watching me, if I make a mistake they will think I am stupid.” Or “If my presentation isn’t flawless, I will lose my job”
  • Probability overestimation – “Even if I study a lot, I still won’t do well on my exam.”

What happens in the above statements is that there is no room for life; because perfect isn’t defined and the intent hasn’t been identified, there is no way to determine success. There are always things we can do differently or do better in the future, that’s part of the learning curve of all life’s situations. Perfectionists have a hard time thinking about what success looks like ahead of time, instead they look retrospectively and judge themselves harshly for the things they “should” have known, never accounting for the fact that these things could not have been known at that time.

Here are some questions to ask yourself to make sure you aren’t going into a perfection obsession.

  • What is the intent? (really think about it)
  • Are the thoughts and actions you are engaging contributing to or detracting from the intent?
  • Are you enjoying it? (If the answer is no, ask yourself 1. Why am I doing this (i.e. is it aligned with my intent or my need to be perfect)? 2. What about this am I not enjoying? 3. Could I approach this differently to feel better about this?
  • Am I being competitive? (With myself? With someone else?)
  • Am I willing to ask for help? (perfectionists tend not to ask for help and/or have trouble truly delegating, also known as micromanaging)

 

Be kind to yourself, be kind to others, and keep it moving.

 

Ashley Steelman, MSW

The Continuum of Trauma

Trauma is becoming a household concept in the past decade, as we see the many atrocities that are going on around our world and in our own communities. Now many organizations are placing a significant focus on raising awareness of how trauma affects individuals, families, and communities. We hear a lot about trauma and PTSD, they have become buzz words we use to describe war scenarios, domestic violence, and other tragic life events. We hear the word and maybe we have a clear concept of what it is or what we think it isn’t, but the surprising reality is that trauma can be present anywhere at any time. How so? Well, it happens on a continuum.
In the mental health community trauma takes two forms, Big “T” and Little “t”. It’s fairly intuitive, the Big “T” traumas are the classic examples of trauma, it’s the BIG events, like car crashes, sudden death of loved ones, natural disasters that sweep away communities, sexual or domestic violence. Makes sense right? These are the jarring events that leave us questioning, searching, lost, confused, and angry (all at once or in progression). They are the events that are readily recognizable as overwhelming, the events that have awareness groups rallying in line to support survivors of the tragedy. There’s an outcry to help these survivors and an increasing inventory of programs and services available to inform, normalize, and process the aftermath of the Big T.
Little ‘t” traumas are often overlooked. Its death by a thousand cuts… it’s the little inconveniences that send you into a sneaky hate spiral (click here for a hyperbolic explanation of the sneaky hate spiral). It’s all the little jarring things that happen throughout the course of the day, week, or month that progressively add up. Without the necessary skills or supports in place to counter or process these “mini” stressors our systems (mind, body, spirit) get overwhelmed. Little “t” can be things that are recognizably stressful like a new assignment at work or be the minutia that builds and ultimately overcomes us, leading to the same mental chaos as the Big “T”; the problem is that we don’t realize our systems are overwhelmed by all these “small” things until our health or sense of peace suffer.

The beauty of it is that solutions are available. Since this is a therapist writing for a therapy blog, I’ll bet you are thinking I’m going to recommend it as a first line of defense. Surprise, that’s not the case! What I would recommend is slowing down, easier said than done, but give it a try. We spend so much time and place so much emphasis on being perfect and having it all together all the time that we forget to step back and appreciate the little positive moments or don’t take time to process and rebound from the little negative ones.

Try the tips and tricks below to help manage the Little “t’s”; if that isn’t enough, therapy is always an option. There is no shame in asking for help or in seeking new tools and resources to get you over a hump.
• Breathe – use the power of breath to literally breathe life back into yourself
• Body Check – keep an eye on where you hold your tension, the more aware you are the easier it is to see when your body is feeling overwhelmed, even if your mind is telling you to push through it. When you feel it, take a step back and let yourself recover.
• Find an Outlet – everyone’s is different. If you don’t find joy or peace in running don’t run, if yoga isn’t your thing don’t do it. The goal is to find a thing that works for you.
• Put it in Perspective – it takes a little practice but try the rule of 10’s. When you are feeling anxious or overwhelmed ask yourself what impact the outcome of whatever you are focused on will have, really… will this matter in 10 minutes (the guy that cuts in front of you on the freeway), will it matter in 10 days (the balloons you forgot to pick up for the birthday party), will it matter in 10 months (the exam you did poorly on or the job interview that didn’t go so well), will it matter in 10 years (the relationship with your friend or significant other that is in a rocky spot).
o In short, put the level of energy you give something some perspective. Life isn’t perfect and it doesn’t have to be. Some of the best moments are in the mishaps and I am pretty sure no one is on their death bed commiserating over the person that cut them off in traffic 40 years ago. Essentially, let the small things, be the small things.
• Find a Friend – countless studies have been conducted showing how social support mitigates the negative impacts of stress. Meaning the Little “t’s” don’t build as quickly or as uncontrollably when we have healthy social supports to help us process (or vent) our stressful days. Side note: don’t let the venting become the premise of the relationship, that doesn’t do anyone any favors. Allow yourself one cup of coffee and one conversation, then move on.
When you feel like these basic tactics aren’t enough, it might be time to seek professional help. When Little “t’s” overwhelm us we often become anxious or depressed, which can skew our decision making and behaviors, which in turn keeps us in a rut. This is where a professional can help you peel back the proverbial layers and help you reverse or counter the things in your life that aren’t working for you. It’s always OK to ask for help and there is always light at the end of the tunnel.

Be kind to yourself, be kind to others, and keep it moving.

More Information on Trauma:
http://www.prolificliving.com/100-positive-affirmations/
http://www.trauma-pages.com/
http://www.nctsn.org/resources
https://www.psychologytoday.com/basics/trauma
http://www.helpguide.org/articles/ptsd-trauma/emotional-and-psychological-trauma.htm 

 

Written by Ashley Steelman, MSW

Ashley