compassion – Natalie Mills, San Francisco Psychotherapist, Trauma Specialist

“It’s Chaos. Be Kind.”

December 11, 2017September 2, 2018

“You think your pain and your heartbreak are unprecedented in the history of the world, but then you read. It was books that taught me that the things that tormented me most were the very things that connected me with all the people who were alive, who had ever been alive.”

-James Baldwin

Not often enough is each of us asked, “What’s it like moving through the world as you?” We are not often asked about our fears and insecurities, hopes, frustrations, and about what makes us feel alive. We are not often asked about what we’re thinking, what we’re wondering about, or if we’re worried.

Some of us experience racism and homophobia. Some of us experience ableism or transphobia or sexism or classism or ageism.

Some of us suffer from depression, crippling anxiety, post-traumatic stress symptoms, chronic pain, or addiction. Some of us are navigating the complicated mourning process and feeling what can only be described as unyielding fragility. Some of us are numb.

All of us are grappling with something- marital problems, financial instability, a terminally ill child, a best friend dead from aggressive cancer, panic about the future, historical or intergenerational trauma, chronic mental or physical illness, a break-up, discrimination, sexual harassment, the aging process, our own inexorable thoughts.

I get the pleasure and honor of creating a space for people to sit down and tell me about what it’s like for them as they move through the world. I get to see couples learn, for the first time, in a deeper way what it’s like for their partners to be them. I have made a career out of witnessing what happens when people speak honestly and listen compassionately.

Not everyone has the privilege of making this their daily life, and I’d like to help make it as accessible as possible. It’s the act of intelligently tuning into our own experience and seeing what’s there. It’s the act of deepening our understanding of ourselves and another.

When we become attuned to and present with our pain, we can tune into and be present with another’s pain. The reverse is also true, that when we are present with and attuned to another’s pain we can also be present with our own. We are complex creatures, capable of many things, some being empathy and compassion.

When we open space for ourselves to be present and attuned, it’s easier to listen to what is really being said. It’s easier to see someone for who they are instead of our projection of them.

We can’t do this all the time, but we can do it more often. We can slow down and drop in.

A client recently recommended I watch Patton Oswalt’s “Annihilation” performance. In it, he talks about his late wife, writer Michelle McNamara, and her belief system. He quotes her as saying, “It’s chaos. Be kind.”

There is chaos. And there is kindness.

I wonder, what’s it like moving through the world as you?

Love and Be Loved,
Natalie

I am a licensed mental health professional serving Portland, OR. 97205.

6 Steps to Trusting Yourself

October 17, 2017October 23, 2017

“The suffering itself is not so bad; it’s the resentment against suffering that is the real pain.”
-Allen Ginsberg

When I first started my own work with mindfulness and radical acceptance, I found myself saying, “I’ll accept this feeling/ this symptom so that I don’t have to have it anymore.” That’s… not really acceptance but it was the best I could do at the time. Since working with clients around mindfulness and radical acceptance, I have heard this sentiment hundreds of times. It’s hard to get behind the idea that accepting our pain or feelings or aversive experiences has therapeutic value, that it could ever help us to make positive changes. Acceptance and Commitment Therapy is driven by just this, accepting the hard-to-accept.

Acceptance and Commitment Therapy was created by Steven Hayes in the early 1980s and tested by Robert Zettle in the mid-1980s. It is a form of Cognitive Behavioral Therapy (CBT) and is based on Skinner’s Radical Behaviorism. Acceptance and Commitment Therapy’s (ACT) main objective is to help participants turn toward their feelings and symptoms instead of resisting them. The protocol helps participants learn how not to overreact nor underreact nor altogether avoid the associations with these feelings and symptoms. With ACT, we learn to accept ourselves and the experience we are having in the present moment so that we can commit to a behavior aligned with our values.

ACT succinctly describes the change in psychological flexibility in this way:

We go from F.E.A.R.

F- fusion with our thoughts

E- evaluation of our experience

A- avoidance of our experience

R- reason-giving for our behavior

To A.C.T.

A-accept our reactions and be present

C- choose a valued direction

T- take action

In the book, Acceptance and Commitment Therapy: The Process and Practice of Mindful Change by Hayes, Strosahi, and Wilson, we’re given the six core principles to help us develop psychological flexibility:

Cognitive de-fusion: Learning methods to reduce the tendency to reifythoughts, images, emotions, and memories.
Acceptance: Allowing thoughts to come and go without struggling with them.
Contact with the present moment: Awareness of the here and now, experienced with openness, interest, and receptiveness.
Observing the self: Accessing a transcendent sense of self, a continuity of consciousness which is unchanging.
Values: Discovering what is most important to oneself.
Committed action: Setting goals according to values and carrying them out responsibly.

ACT emphasizes mindfulness because presence of mind/contact with the present is the only way to change behavior. Now is the only time that we can truly choose a behavior. We habituate to looking at the world in a certain way which makes us miss important external and internal cues to help us determine what is happening in the present moment by thinking about the past or the future. Awareness of the present moment helps us to differentiate between what we are afraid is happening and what is actually happening. It helps us to describe what is happening and then make choices in response. Jon Kabat-Zinn describes mindfulness as “paying attention in a particular way, on purpose, in the present moment, and nonjudgmentally.”

The “acceptance” part of ACT is problematic for some. “So then, if I’m supposed to accept my feelings and my experience, does that mean I’m supposed to accept abuse and maltreatment?” The answer to that will always be no. When we accept our feelings and experience, it means we accept the information that we are receiving and can make choices based on that information. It means that we accept that this is how it is right, not that this is how it should continue to be.

When we practice acceptance of what’s happening we can mindfully make choices that are in alignment with our values. I like to use this phrasing in my own life and when working with clients: “I’m going to keep choosing the same behavior of ______ because I care about______.” Or “I’m going to change my behavior to ______ because I care about ________.” So, someone might say “I am going to keep choosing the same behavior of confronting people when they treat me with disrespect because I care about my feelings and how I’m treated.” Or “I’m going to change my behavior to respectfully disengaging from an argument when it no longer feels productive because I care about my feelings and this relationship and I know that continuing in unproductive conversation usually leads to hurt feelings and resentment.”

Sometimes the choice is hard to make. For instance, “I choose to go to bed earlier so that I can wake up feeling more refreshed” is a great behavior goal. But what if it means sacrificing quality time spent with loved ones? This is where present moment focus and acceptance of your experience comes in handy. You might prefer to spend the time with your loved ones and wake up feeling a little more sluggish.

I know it’s hard to identify choices so let’s do it together. If you want to talk more about Acceptance and Commitment Therapy, changing behaviors, or anything else, please call or email me.

Love and Be Loved,
Natalie

If You Want to Be Heard, Start Listening

September 27, 2017

A lot of couples seek therapy looking for help with their communication. They want to feel seen, heard, and understood. Pretty much all of us want to feel this.

Often, what ends up happening is a lot of talking and explaining and scrambling but not a lot of listening. We want to be heard before we hear. We want to be seen before we see. It becomes a rigid bartering system with the understanding that “If you listen to me and understand what I’m saying, I’ll listen to you and try to understand what you’re saying.”

And it’s understandable. When an intimate relationship is fraught with miscommunication and misunderstanding, there are wounds. There is pain. Most of us don’t know how to navigate our pain and the pain we’ve caused our loved ones. We are defensive when confronted and quick to point out what the other has done to hurt us. It’s hard to forge ahead together with this strategy.

If we’re unsure of how to navigate our hurt, we usually use anger as a secondary emotion. During an intense discussion or argument, we become angry enough that we forget we love the other person. Our stance becomes adversarial, and in a minute we say something deliberately hurtful. This kind of defense amplifies our communication problem and is a devastating hit to emotional intimacy.

In the heat of the moment, it’s hard to slow down. It goes against everything our nervous systems are telling us to try hear and see the other person’s experience. But if we want to deepen and maintain our bonds, we have to learn how.

When we’ve experienced trauma, hearing and seeing while regulating our emotions is especially hard. Fatigue, hunger, and loneliness also stack the odds against us. There are a million reasons that contribute to the challenge of hearing and seeing. And there is one big reason to keep trying- increased peace and understanding within ourselves and our relationships.

To be proficient in inquiry of others’ experience, it’s helpful to start to with ourselves. It’s also helpful to start by being pretty basic about it. Initially, try it when you’re feeling relatively calm. Pause and see what you notice. What’s happening? What do you hear? What do you smell? What do you notice in your body? Then, try it when you’re feeling slightly irritated. The more you practice it (or anything), the more available it will be to you when you need it. Eventually, you’ll try this when you are really struggling whether on your own or in relationship. If you’d like to talk more about this or have any questions, feel free to reach out.

Love and Be Loved,
Natalie

Black Lives Matter

September 13, 2017September 24, 2017

As a practitioner in the helping profession, it is my job to help people thrive. None of us can truly thrive if groups of us are being singled out, mistreated, attacked, harmed, and killed. The Black members of our communities continue to experience this.

It is my responsibility as a member of this community, health practitioner, and white-presenting person to use every platform I have to address issues of injustice and inequity in my community to communicate that this community cares about what happens to you and we will fight alongside you for your rights and your lives. Racism oppresses, harms, and kills.

Yes, all lives matter, but here in the United States, Black lives specifically are historically and consistently undervalued. It does not devalue anyone’s life to say that Black lives matter. If it offends you or is uncomfortable for you to hear the phrase, “Black lives matter,” consider the reasons why a group of people in our community feels like they need this movement. Consider why this movement is criminalized. What must their experience be like if they are so vocal about this movement? One group is saying, “All lives matter,” while another group is saying “Stop abusing and killing us.”

White people are often afraid to talk about racism. Many of us feel uncomfortable around it and silence ourselves. Our silence is unacceptable and is a very real, harmful symbol of our agreement that some lives are more important than others. It is a clear sign of our privilege that we are afraid to have uncomfortable conversations about race while Black people are afraid for their lives. As people who hold privilege, it is our responsibility to talk openly about racism and how we can work to eradicate it. It is our responsibility to keep learning and unlearning, growing and changing, and to be better for our community members who deserve our respect, our voices, and our solidarity.

“I Love My Kid but Hate Parenthood.”

July 25, 2017

A while back, I wrote a post directed toward parents who regret parenthood. And I don’t just mean sometimes. I don’t mean that “Ugh, I hate this part,” feeling. I mean the whole thing, the conflict of loving their children but hating the entire process.

I’ve received a lot of feedback about it. Many people were grateful and expressed that they’d been feeling alone with their guilt and regret. Feelings are complicated, people are complex, and our culture is still learning how to accept and hold all of this. My message was that it’s ok to regret or hate parenthood, that it’s ok not to feel as though you were cut out to be a parent whether your kid is 3 months, 2 years old, 6, 10, 16, 22, or 27 years old. It seemed to resonate with a lot of people.

There’s a theory developed by Donald W. Winnicott called “The Good Enough Mother.” It was developed in the culture of the 1950s which is why it only refers to the mother. It’s more complicated than the title suggests, but basically, he tells us that parents should slowly titrate the soothing to their children’s frustration, that parents should slowly and methodically transition from immediately meeting a child’s needs to letting the child self-soothe and learn how to get their needs met. But that’s not all. Upon further study of his theory, we find that Winnicott talks about the dangers of chasing perfect parenting. He cautions that striving for perfect parenting does a real number on developing brains.

Over the years, I have seen a lot of parents, families, and children. I’ve seen parents who wanted children from the time they were children, parents who somehow found themselves suddenly parents, and parents who figured they’d want kids some day, so they had them. A significant amount of these parents realized that they didn’t like being parenthood. Not only was it different from what they’d envisioned; it turns out the whole thing (or much of the thing) felt completely contrary to everything they wanted.

These parents have struggled with regret, guilt over the regret, anger over what they feel they’ve missed, and angst over how this might impact their children. (Although, there have been some parents who swapped their angst and guilt for denial.)

These parents need to hear that they don’t have to love parenthood to love their kids.

There are a million reasons not to love parenthood- poverty, any and all of the –isms, trauma, lack of a support network, disliking our own children, resenting the responsibility and experiencing it as an unwanted burden.

If you are a parent who regrets or hates parenthood, you’re not alone. You deserve compassion and respect. I know it’s taboo to regret something society tells us is the pinnacle of love and value and meaning. If you would like therapeutic or referrals for adjunct support, please call or email me.

Love and Be Loved,
Natalie

Say It Better

June 14, 2017

It occurs to me every so often that my job is instrumental in helping me manage life. I’m really lucky. I get to spend my days learning about what works and what doesn’t and for whom. I get to talk and think all day about the human brain and its connection with the body, what to do when we find ourselves in various pickles, and best practices for increasing our well-being. Sometimes I don’t realize how much I take for granted. Last week, I realized how much I take for granted having a constructive conversation.

All the time (and I mean, constantly) I hear people say to one another, “How many more times are we going to have this conversation?” or “How many times do I have to tell you?!” or “How long are we going to have to keep revisiting this subject until you finally get it?” Most of the time the answer to that question is- however many times it takes because we don’t learn from lectures and conversations and words alone. Our most effective preceptor is experience. So, on the one hand, when a need or a goal is really important to us, and we feel it’s not being met, we can definitely count on having multiple conversations about it over and over and over. We might as well make ourselves a little more comfortable and feel a little less crazy by learning how to practice and apply effective conversation skills.

You might remember from the 80s, the T.H.I.N.K. method for communication (which I’m not totally sure but I think might have been founded on some Buddhist principles for wise speech).

At some point, you probably saw the poster for it in a humanities class, at a presentation given by your Human Resources department, or on a wall in your kindergarten classroom. Decades later, most of us have forgotten the message brought to us by that wise little poster. At any rate, it said:

Before you speak,

T- is it thoughtful?

H- is it helpful?

I- what is my intention?

N- is it necessary?

K- is it kind?

And honestly, it’s a technique that I use every day, both at work and in the rest of life. We cannot underestimate the healing power of deliberate and compassionate communication. I’m going to break it down with some more questions for deeper self-inquiry. The T.H.I.N.K. method is always simple, but it’s not always easy.

T- it is thoughtful:

Have I reflected on my experience to optimize this conversation? Am I fully present for this conversation or am I feeling pretty reactive right now? Am I clear on my message, needs, experience, and feelings? Is this a good time for each of us to talk about it?

H- is it helpful:

Does this help the other person understand my experience? Does it help me express my feelings and needs? How will it help our connection?

I- what is my intention:

What do I want the other person to know about how I am feeling and what I need? What do I need from this interaction?

N- is it necessary:

Is what I am about to say critical to my message? Is it essential to understanding my experience?

K- is it kind:

Am I approaching this conversation with the utmost dignity, respect, love, and compassion for myself and the other person? If I am feeling reactive, am I trying to hurt the other person so that they feel what I feel? For both of us to get the most out of this, do I need to pause or take a longer break before I continue this discussion?

Sometimes it’s not possible to be this thoughtful. We’re people, and we react when we feel strongly about something. Sometimes we act or speak impulsively. And sometimes others can’t or won’t hear us no matter what. And sometimes there just isn’t time and space. Our world moves at hyper speed, and we are pretty consistently pressured by this. But when we can pause for a minute, reflect, and inquire, we give ourselves and others the gift of clarity. Over time and with practice, we find that this quality of communication paves the way a deeper insight. This is crucial for changing behavior and patterns. Go forth and effectively communicate.

Love and Be Loved,
Natalie

Jumpstart Your Compassion

February 7, 2017July 24, 2017

I talk a lot about compassion on this forum. I’m a big fan. Throughout my years of working in mental health, providing clinical therapy, and immersing myself in the research I’ve come to understand that compassion plays a critical role in our human lives, the way we behave, and how we feel.

Buddhists and Buddhist Psychologists define compassion as being made up of two parts- 1) empathy, being able to put yourself in someone else’s shoes, and 2) action, extending your felt sense of empathy to do something about it. I like that. It’s a gentle but clear way of saying, “Don’t just feel for the person. Do something about it.” Feeling and action cause change.

There are as many reasons as there are people why it might be challenging to tap into our own compassion. Many of us don’t believe we hold enough power to effect anything worthwhile or sustainable. We feel beaten down, afraid, over-worked, alone, inadequate. Some of us even use denial to medicate our guilt and powerlessness by telling ourselves things like, “Oh, that group is suffering probably because they’ve done something to deserve it,” and “It’s probably not really that bad. Besides, I’ve got my own problems to worry about.”

If I cut myself off from feeling empathy because it is accompanied by feelings of sadness and guilt, it means that I am out of integrity with myself. If I am out of integrity with myself, that means I invite a whole treasure trove of other hard-to-feel feelings- blame, anger and of course more sadness and guilt. I’ll experience blame and anger because, in the short term, it is easier to get angry and blame someone who is suffering than to feel powerless to help them. It is easier to look down from my high horse on someone who is suffering and have the gall to find a reason as to why their suffering is their fault. This propensity is in all of us. We have all been in situations where we have seen suffering and not extended ourselves. We have all been in situations where we have witnessed injustice and not intervened.

In their book, Mindful Compassion, Paul Gilbert and Choden reflect that “Perhaps one of the greatest enemies of compassion is conformity; a preparedness to go along with the way things are, sometimes out of fear, sometimes complacency, and sometimes because we do what our leaders tell us what to do.” It’s hard to act compassionately, especially when our first instinct is to protect ourselves.

There are times when it is easier for us to feel compassion for others and times when it is easier to feel self-compassion. In those moments when we feel more challenged by finding compassion for others, a good way to jump start it is to practice self-compassion:

1) We can identify our feelings and try to define the experience we’re having.

2) We can accept our feelings and the experience we are having.

3) We can acknowledge what connects all beings- the desire to be free, happy, and loved.

4) We can acknowledge compassion that has been extended to us.

Like almost everything else, this is about perpetuating patterns. What we practice will continue. What our brains practice will help strengthen those neural pathways creating our neural circuitry.

“Until he extends his circle of compassion to include all living things, man will not himself find peace.” (Albert Schweitzer)

Love and Be Loved,
Natalie