self-care – Natalie Mills, San Francisco Psychotherapist, Trauma Specialist

5 Books to Read When You’re Struggling to Live Life

January 16, 2018September 2, 2018

Those of us who have experienced relational trauma understand the discomfort of being in our own bodies. We understand how unnatural it feels to self-advocate and take care of ourselves. (And I mean actual self-care, not just rigidly refusing to lean on anyone else.) We understand what it’s like to live our lives and make choices based in fear. I have put together a list of five books that I often recommend to clients who want to improve their self-care, learn how to set better boundaries, communicate more honestly and effectively, stop being controlled by their fear, listen to, understand and respect their bodies, support themselves, deepen intimacy, and stop dysfunctional behaviors that are hurting their ability to connect.

Codependent No More: How to Stop Controlling Others and Start Caring for Yourself by Melody Beattie

This is one of my top favorite books of all time, and I recommend it to anyone who is or has ever been a caregiver in any capacity and to those working in helping professions. The term “codependent” was popularized by Melody Beattie in the 1980s, but no one’s sure who coined it. (Although many people have taken credit for it.)

Its definition was hard to narrow down to a succinct phrase since there are so many behaviors and reasons for those behaviors that fall under the umbrella of being codependent. Most of us agree that the heart of codependency can be defined as behaviors employed in the attempt to control someone else’s behavior so that the codependent can get their needs met and whose behavior keeps them from getting their needs met. It’s when we make someone else’s problem our problem.

The term was originally used to describe loved ones of addicts, but we don’t need to be in a relationship with an addict to be codependent. People who have been abused, raised by parents with personality disorders, loved ones of people with eating disorders, those with an anxious attachment style, those who are caregivers, people in helping professions, or people with otherwise lower self-worth can find themselves demonstrating codependent behaviors.

Like pretty much all things, codependency is a spectrum. Some of us have more traits than others and demonstrate them more or less often. The author understands that when we are trying to control someone’s behavior, trying to get them to do something or stop doing something, we do things “at” them (use substances, clean, make a passive aggressive comment, nag, sigh loudly, eat, starve, spend money, etc.). There are endless ways that we might try to persuade someone to change their behavior. This book helps us to see that we’re already holding the key to our own prison.

Codependent No More is an invaluable box of tools that teaches us to identify the problematic and controlling behaviors we use in an effort to get our needs met/avoid being abandoned and teaches us how to create healthier, more self-supportive behaviors for ourselves. In an honest, nonpathologizing approach, this book shines a light on why we’ve come to behave this way in relationship, our thinking, and self-beliefs behind the behaviors, and walks us through other options.

It’s essential for those of us who want to learn how to set better boundaries. It’s possible for us to be supportive of others and those in need without becoming completely worn down, exhausted, and bent out of shape. We don’t have to hawk over someone’s problem-behavior, be embarrassed by them, feel like the “mean one” in the relationship, and arrange our entire lives around people.

When someone else’s problem has become our problem and we’re tired of feeling helpless, frustrated, and resentful I recommend reading Codependent No More. Stop doing more than we can do.

I also recommend the Codependent No More Workbook for those who want guided practice of these new healthy behaviors.

Nonviolent Communication by Marshall Rosenberg

When we’ve been oppressed, marginalized, or abused we usually don’t see our options. We either react or see our choices as a series of ultimatums. We believe that people, places, and things can “make us feel” a certain way. It’s the old, “I only did that because you completely infuriated me.” We speak the languages of blame, shame, and guilt. We don’t understand accountability, personal responsibility, and choices.

We’re used to living stressed out lives. We’re habituated to feeling controlled in our relationships, at work, in life. We’ve acclimated, but it’s not a normal way of living. Trauma symptoms are often described as “normal reactions to abnormal situations.” Many of us have either experienced abnormal situations growing up or have grown accustomed to living life as a continuous series of abnormal situations, often both. We end up normalizing disempowerment. We believe that others hold our happiness in their hands.

Nonviolent communication is so much more than the name lets on. It’s about recognizing our choices and acknowledging the difference between our backs being up against the proverbial wall and feeling as though they are. It gives us tools to understand how we’ve interpreted an event, teaches us to identify our feelings about it, helps us to see our choice of response to the event and our feelings about it, and how to take responsibility for our feelings and choices.

We learn to stop trying to control others’ behavior and beliefs. Our intention shifts from trying to get something from another person to clear, honest communication for the sake of our integrity, sanity, and wellness. We learn to employ curiosity to deepen understanding of our experiences, of others’ experiences. Through the practice of nonviolent communication, we start the process of transforming our judgments. We create more space between ourselves and reactivity.

We land the jump from, “I yelled at you because you made me mad,” to “I yelled at you because I’ve been feeling overwhelmed and insecure about a lot of things. I interpreted what you said as dismissive and felt sad and outraged. I lost it.” The practice of nonviolent communication helps us to see our part in things, that everything isn’t our fault and everything isn’t someone else’s fault. It gives us the freedom to identify our responsibility in a situation, to own it, and, realizing we can’t control other people, to let the rest go.

The Places That Scare You by Pema Chodron

There are myriad books about humans’ innate fear of death, but I’d always found a shortage of discourse about our fear of life. I came across this book ten years ago, and it pointed me in the right direction. (As it turns out, there is much discussion on our fear of living in psychospiritual literature.)

In The Places That Scare You, Pema Chodron talks about the common human fear of living our lives. Most of us experience this at one time or another, but those of us who have lived through extended relational trauma often experience this fear more chronically. We feel anxiety about everything- doing something, not doing something, going somewhere, leaving somewhere, falling in love, never falling in love, staying stuck, making progress, literally anything. We are anxious all the time and driven into depression from our lack of traction.

Pema Chodron helps us to reconnect with our inner intelligence that allows us to interpret our fear and helps us to find ways to support our fearful parts. Her book shines a light on the path back to self-trust and resilience. We learn to listen to our experiences, take care of ourselves around fear and pain, and reemerge from our protective shell.

Above all, the message in this book serves as an encouraging and insightful guide to allowing people and circumstances to be whole in their complexity. It’s possible for us to hold all of our experiences without having to over-compartmentalize. We can handle disappointment, hurt, and anger without having to permanently retreat.

Pema introduces us to the simple application of gentle curiosity. When we practice this, eventually, we begin to recognize what our fear is telling us. Using our own intelligence, we can identify, accept, and respond to our needs.

BodyWise: Discovering Your Body’s Intelligence for Lifelong Health and Healing by Rachel Carlton Abrams

When we’ve been physically, sexually, emotionally, or systematically abused and traumatized, we have felt unsafe in our bodies. Even having a body has felt unsafe. Many of us have depersonalized to the point of being unaware of our biological needs and urges (hunger/satiety, thirst, body temperature, pain, urination, and other body sensations).

Our bodies hold valuable wisdom. They communicate all sorts of information to us like when we are getting a bad feeling about someone, when we need more protein, when we’re relaxed, when something is working for us, when something needs to shift, when we need attention and help. If we are cut off from our bodies, we are cut off from that intelligence.

In BodyWise, we find helpful, detailed techniques for establishing a safe and empowered connection to our physical bodies. If we’ve been struggling, it’s possible for us to feel at home in and accepting of our bodies. Dr. Abrams offers an insightful 28-day program for bringing physical and emotional healing and balance to our bodies. This program is most empowering because rather than presenting general tips, it requires a detailed self-assessment. This makes the program unique for each participant.

Dr. Abrams’ gives clear, accessible advice for exploring and taking ownership of our physical health (or unhealth). Her approach is nonpathologizing, direct, and humorous. She reminds us that we can have a safe, loving, intuitive, and supportive partnership with our bodies.

Self-Compassion: The Proven Power of Being Kind to Yourself by Kristin Neff

Self-compassion is still making its way into mainstream culture. While it looks like mainstream culture isn’t quite finished strong-arming itself, a lot of us are. People who are tired of living a life of self-criticism, blaming others, perfectionism, chronic overwhelm, and disempowerment will find great refuge in this book.

Those of us who have experienced any form of relational trauma are not well-practiced in the art of self-compassion. We know how to care-take, anticipate the needs of others, turn off our own needs for long stretches, blame others for our feelings, blame ourselves, guilt ourselves, and are experts at all-or-nothing thinking. In fact, due in large part to our conditioning, most of us are pretty sure that self-compassion is synonymous letting ourselves off the hook or getting away with something.

Self-compassion is “self-kindness, common humanity, and mindfulness,” as defined by Kristin Neff, author of Self-Compassion and leading researcher of this subject. When we extend compassion to ourselves in difficult times, we offer support to ourselves. Here is an exercise called “Self-Compassion Break” taken from her book:

This is a moment of suffering (or difficulty).

Suffering (or difficulty) is a part of life.

May I be kind to myself.

There is no letting ourselves off the hook or getting away with anything. There is only acknowledgment of our experience, validation, and support. If it is hard for us to accept outside support, this is a soothing exercise. If we feel like we can never get enough support from others, this is also a great exercise. There’s power in our ability to face our experiences and offer ourselves support and kindness.

In this book, Kristin Neff guides us through the demystification of self-compassion, clarifies what self-compassion is, why it’s necessary and teaches us direct and accessible daily practice.

If we are struggling with shame, guilt, and anger, this book is especially helpful for us. It doesn’t sugar-coat a situation. To be sure, the tenants behind the practice of self-compassion encourage us to look honestly at whatever we’re dealing with so that we can support ourselves, ask for help when we need it, and respond in alignment with our values.

Like all self-help books and therapeutic tools, these books are only as useful as the reader is willing to put their advice into action. Sometimes it takes a few rounds of reading them. Sometimes we need to be in therapy and go through them with a skilled clinician. If you have been thinking about starting or going back to your own therapy process and have any questions about next steps, please contact me for help.

Learning to self-advocate is not easy, especially if we have received messages that it is not safe for us to do so. And often, in some way or another, we have. Self-care and self-support do not always come naturally to us. And making choices based in fear often seems like the only available option.

While these books are not the silver bullet we’ve been waiting for, they are helpful tools, and the authors offer deep insight into healing our physical and emotional selves. We can learn to live more fully and authentically, communicate more directly, self-advocate, and participate wholeheartedly in our relationships.

We have been living in a dim room with one arm tied behind our backs. There is hope for illumination and freedom. We don’t have to struggle through life. We can accept ourselves, feel at home in our bodies, and respond to issues in our lives healthfully and skillfully.

Love and Be Loved,
Natalie

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

The Agony of Codependent Boundaries

January 2, 2018September 2, 2018

Those of us who experienced relational trauma at an early age either weren’t taught how to have clear, predictable, and logical boundaries or had that training interrupted. Chances are, we do not know how to set those kinds of boundaries for ourselves now. In fact, we probably have a skewed idea of what healthy boundaries look like. We might think it’s our responsibility to prevent others from getting mad or sad. We might have had to do this to keep ourselves safe during childhood. We might think it’s perfectly acceptable to micromanage someone else’s choices. (And we probably don’t see it as “micromanaging.” It’s more likely that we see our behavior as helpful or supportive.)

There are a million examples of unhealthy boundaries (or lack of boundaries). Here are a few common ones:

Saying yes when we mean no.
Trying to control someone else’s behavior or choices.
Being unclear (with ourselves and others) on what we’re willing to tolerate and what we’re not.
Not telling the truth about what is working for us and what isn’t.
If we break a commitment to someone, being dishonest with them about why.
Not saying how we feel because we think someone doesn’t want to hear it.
Being unwilling to end a relationship if that relationship has become nonreciprocal.
Not letting people have their feelings when we say no or set and hold a limit.
Not Accepting someone else’s limits without becoming defensive or punishing.

It is understandable that at some point, we learned that we would be safer or more effective at getting what we wanted if we demonstrated these behaviors. As adults, though, most of us have found that they no longer serve us. We understand that these behaviors keep us from genuinely connecting with ourselves and others.

See if this scenario sounds familiar. Your partner tells you he’s been working really hard, is tired, and needs a break. He asks if you’d mind if he took a long weekend away with some friends to blow off some steam. This is the third recreational trip he’s taken without you in four months while you have not taken one in two years. You have also been working hard, are tired, and would like a weekend away with your friends. If you say no, you don’t mind, it will mean managing your fulltime work schedule, your two-and-a-half-year-old, and preparing for the week-long visit from out-of-town family you’ve scheduled for the upcoming holiday week. If you say yes, you absolutely mind, it will mean disappointing your partner. You say yes, throw this newest resentment in your resentment bank, and martyr through. He has a great time and comes back feeling refreshed.

The fact that you said yes to the trip isn’t what makes this an unhealthy boundary. Plenty of partners trade off taking separate vacations. It’s the fact that you haven’t traded off taking vacations in years, said yes when you meant no, didn’t tell the truth about what’s working for you and what’s not, and silenced your feelings to keep your partner from feeling disappointed.

Sometimes we confuse boundaries with controlling behavior.

Boundaries involve choices, what we are willing to do and accept and what we are not, and our behavior that we can control. “I won’t answer your call if you call after 9:30p.” Or “If you continue to talk to me this way I’m going to leave.” Or “I can’t help you with that right now. If you still need help in a couple of hours, try back then.”

Controlling behavior is manipulative and often passive-aggressive. “I told you I’d leave you if you didn’t stop drinking and start going to AA so, I’ll take you to your AA meeting to make sure you go, wait outside to see if you stay, and pick you up to make sure you don’t go to any bars or liquor stores on the way home.” Or “I hate the way she talks to me. I’m going to give her the cold shoulder whenever she says something in a way I don’t like so that she gets the message.” Or “I’m making plans with a friend for next week even though I might not feel up to hanging out with them. I want to please them in the moment. Rather than making tentative plans, I’m going to cancel last minute because I don’t want to deal with them feeling frustrated or disappointed with me right now. I’ll just avoid them for a few days after I cancel our plans and then go on as if nothing has happened.”

We exert control over people or situations instead of setting boundaries so that we don’t lose the relationship or situation on which we are dependent.

Weak boundaries often flop either way. If we know that we can be pressured into doing something we don’t want to do, we probably assume others can, too. Unconsciously or intentionally, we might apply pressure or bulldoze to get someone to relax their boundaries.

We’re afraid to set boundaries because we don’t want to deal with what happens when we keep them. We don’t want to have to hold the limit with our children or parents or partners or friends or coworkers. Boundaries are painful. They take work and commitment. It hurts when someone is mad at us or when we have to separate from them for a while or for good.

Instead, we try to show someone how frustrated or scared or sad we’re feeling by saying mean things, doing things “at” them (drinking, stomping around the house, eating, starving, literally anything), making empty threats, tantruming, or shutting someone out for a day or two. If we weren’t allowed to set boundaries as children, if our boundaries weren’t respected, or if we never learned how to set boundaries, we’ll be well-practiced at power struggling and weak at boundary setting as adults.

A sneaky way for us to fall off our boundaries game is the urge to care-take.

We give advice or help without being asked. We insinuate ourselves into someone else’s situation and micromanage them. We rescue people, do for them, give to them because we want to feel needed, indispensable, helpful, and lovable. Usually, what happens is the other person starts to expect this from us. They depend on us. We feel good about ourselves knowing that we’re taking care of someone and we wait for the effusive gratitude and love. When the reciprocity doesn’t come, we start to feel resentful because we are doing so much. It’s pretty much doomed from the start.

There is a difference between giving to others and helping people in need and care-taking so that we get our needs met. We give so that we live inline with our values. We care-take in hopes of not being abandoned. When we care-take, the boundary between our responsibility and others’ responsibility is blurred.

Often, we get so sick or run down we can’t perform our care-taking behaviors continuously. Some of us pray for a sick day so that we have an excuse to stay home and not take care of anyone else for a while. Self-care is so foreign to us that we feel we have to justify it through illness or injury. “I’ve been working hard and taking care of everyone else. I’m exhausted and sick as a dog. I deserve to stay in bed and watch TV and rest.” We equate care-taking with earning our keep. Some of us are often sick or inured and use that time to wait for others to give us the same care we’ve given them. This is, of course, a set up for everyone.

The more we give until we’re depleted and neglect our own needs, the more we martyr ourselves, the needier we become. We drive ourselves deeper into emotional debt. Our resentments increase, and we become the dreaded victim.

Being a perpetual victim is exhausting both for us and for the people in our lives. It happens when we don’t take responsibility for our choices and believe that everyone else’s wellbeing depends on us. We say things like, “What am I supposed to do? Not give my sister money when I know she’s struggling with her finances?” Or “Of course I’m going to spend the holidays with my mother. It doesn’t matter if I have a good time or not. That’s not what’s important. What, am I just not going to go and make her think I don’t love her? Then what?” When we are victims, everything we do is a burden. We have to give that unlikable coworker a ride home if they ask. We have to stay at the job we hate. We have to say yes when a family member asks us for a favor. We have to suck it up and give our last piece of energy away.

Sometimes it’s a fine line between care-taking and taking care of our responsibilities. If we are in charge of caring for children, animals, or dependent adults we can’t stop or duties, but we can ask for help and make sure we are meeting our biological and emotional needs. We can make sure that we’re not trying to do more than we realistically can. We can remember that we can say no. Care-taking has the attitude of “I have to do it all.” Boundaries and taking care of our responsibilities are about choices and sound like “This is what it is right now. Is there a way I can approach things differently? Is there a different perspective I can access? What are my choices here?”

It’s normal to want to help someone when we see them in need. Helping doesn’t mean we’re not setting healthy boundaries. It’s not so much the what as it is the how and why. Am I saying yes to this person because I genuinely want to help them or because I’m afraid of losing the relationship if I don’t? Am I straightening the living room because I want to maintain my responsibility to myself and the space I live in or am I doing it “at” the members of my family, huffing and stomping around, trying to get them to see how much I’m doing while they sit there and watch TV? Do I list all the things I’ve done today so that everyone can see how worthy and productive I am?

Loving someone and sincerely wanting to help them means that we will:

Check in with ourselves to see what kind of place we are in to help. If someone asks us directly for our help, it’s always acceptable to say, “Let me get back to you,” and decide what, if anything, we are willing to do.
Pay attention to relationships in which there is low or no reciprocity. Is this working for you?
Notice and be honest with ourselves when we are giving because we want to receive. (Ever heard of “needy giving?”)
Take responsibility for our feelings and choices.
Not take responsibility for other people’s feelings and choices.
Make a deliberate choice to take care of ourselves and stop when we need a break.
Understand that saying no is sometimes the best help we have to offer someone.
Ask ourselves why we feel compelled to help someone and what we’re hoping to gain from it.

The more we trust and accept ourselves, the more we will trust and accept our boundaries and limits. When we’ve experienced relational trauma, our ability to trust and accept ourselves is compromised and sometimes terminated. If we are willing to be uncomfortable as we learn how to identify, set, and hold the boundaries that feel right for us, we will be able to contact self-trust and self-acceptance again or for the first time. We will test patience, fail, disappoint others, feel awkward, and make mistakes. And we will finally learn that we can survive all of those things.

This practice, like so many others, is a slow burn.

Love and Be Loved,
Natalie

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

Trusting Yourself in Times of Failure

December 18, 2017September 2, 2018

So many of us gravitate toward challenging ourselves and our status quo- The Whole 30, New Year’s resolutions, 100 pictures in 100 days, Couch to 5K, creative writing competitions, training for a race. I love getting to see people who want to better themselves preparing to accomplish a new thing or hit a new goal. There’s something inspiring about being around other people who are plotting their next achievement.

A pretty major defining part of a challenge is that it’s hard. We are confronted by parts of ourselves that don’t think we can finish or maintain, parts of ourselves that are afraid of being uncomfortable. We get overwhelmed or don’t see results as fast as we want them, or we lose steam or skip a day/week/month, and we give up and forget about our goals.

This is why we’re encouraged to participate in group challenges and tell other people about our goals. We need each other for support, to hold one another accountable, especially when the going gets tough.

And even then it’s still so easy to slip out of the new routine we’ve created. Little by little or all at once, we find ourselves letting go of progress. We feel defeated, and we berate ourselves for failing to accomplish another goal. We make excuses. Sometimes we punish ourselves. Sometimes we let ourselves off the hook.

But we have another option. There’s another opportunity available to us that doesn’t involve making excuses or punishing ourselves or letting ourselves off the hook. We can begin again.

Sometimes we’ll need to reassess so that we can begin again. It will be hard for us to keep up with the goals we’ve set for ourselves if they’re too advanced for our current skill set or if we’re not listening to ourselves. When we embark on a challenge, we’ll be more successful if we are honest with ourselves and start where we are, not where we wish we were. It’s critical that we listen to ourselves and go back to the drawing board if something isn’t working for us.

Beginning again is an essential ingredient to meeting a challenge. There will, of course, be days where we don’t feel like going for the run, eating the clean meal, sitting down to meditate, going to our wellness appointment, reading the articles, writing the articles. There will be days where we do feel like it, but something prevents us from sticking to the plan. We will have to begin again.

There will be times when we are in the middle of a run or a mediation or a meal or a plan and know that we’re phoning it in or not fully present. There will be moments when our commitment falters. This is an expected and built-in part of any challenge. We’re allowed to struggle and we will. We can accept it and begin again. (Some days, I begin again 25 times during a run. I’ve begun again countless times during meditations.)

We can practice a “begin again” mindset with any challenge, including the daily challenges of life and being a person. We can apply it to driving when we discover our feathers have been ruffled by our fellow road warriors. We can begin again when we’re in the middle of a disagreement with someone, and we don’t like how we’re acting. We can begin again at work.

We can make it as momentous or pedestrian as we want. We don’t have to go anywhere or close our eyes or have a special ritual. It can be as simple as taking a breath and beginning again.

Beginning again marks its own challenge. Play around with it and see what works for you. Be curious about when it seems to be easier and when it’s harder.

Love and Be Loved,
Natalie

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

Your Devotion to Healing

December 4, 2017September 2, 2018

We all want to know how people feel about us. Most of us want to know how our therapists feel about us. “Does he think about me in between sessions?” “Does she think I’m smart? Funny? Doing a good job?” “Does my therapist like me?” I think of clients often, both past and present. In fact, I think of our work together and how I’ve received immeasurable benefit from knowing each and every client.

Every single day I’m aware of the gifts of this profession. I’m deeply thankful and appreciative to be in a position that allows me to make contact with so many different members of my community. I’ve wanted to write a thank you letter to past and present clients for some time, but I’ve been fearful that I couldn’t express my gratitude as clearly as I’d hoped. I decided that it’s better to try than to stay silent.

We start out as strangers. You call or email, looking for help with your pain and suffering, questions, and frustration about your situation. Sometimes you’ve been suffering for years. Other times your discomfort is recent.

I know how hard it is to make that first contact, to come in for the first few sessions, before we’ve established a connection. You feel a mix of trepidation and cautious optimism. You’re afraid I might judge you. You’re afraid of stigma. You’re afraid there’s nothing anybody can do to help you, that you’re beyond hope, but you’re not ready to give up just yet. Thank you for your fight.

You show up and share your history, parts of yourself. You answer my questions. Little by little, you start to let go and engage in the process. You fight against the urge to clam up when you’re visited by self-judgment and fear. Sometimes you win. Sometimes the urges win. You keep trying. Thank you for your persistence.

I am awe-struck by your courage. You’ve been through so much life. We live in similar worlds so, I know that you’re working against years of people telling you to suck it up, that your pain isn’t a big deal, that there is more pain, worse pain out there, and that you’re lucky. I know you tell yourself this, too. But there’s a small part of you that doesn’t believe it. Thank you for your courage to hold onto this small part.

You come to our sessions when you don’t feel like it, when you’re thrown around by life, when you’d rather finish that work project or Netflix show or go out with friends. You come to our sessions when you’ve got a million responsibilities, when you’re afraid to face your feelings, when you’re embarrassed about what you shared last session. Thank you for your commitment to this work.

Somehow, you push through your own self-judgments, fear of judgment from me, discomfort, and you bring your authentic self. You allow yourself to ask revealing questions. You face your vulnerability and insecurity. You tell me what makes you feel joy, loneliness, hate, fear, and rage. Thank you for your authenticity.

For these and so many other reasons, I am inspired by you. You remind me that, while life is undoubtedly a painful experience, it is also wonderful. You remind me that it’s better to take chances instead of staying grounded in fear. Thank you for your inspiration.

You have changed me. I’m not the same person I was before I started this work. You have inspired me to become more self-aware, more patient, more curious, more direct. You’ve inspired me to learn and to embrace my vulnerability, to live more authentically. You’ve taught me to stop getting angry at people for being who they are and instead be curious. You’ve taught me to look and listen more closely and more compassionately. I would not be who I am today without our work. Thank you for changing me.

It is an honor and privilege to work with all of you. I hope my words and actions demonstrate my gratitude for you. Thank you for all you share with me.

Love and Be Loved,
Natalie

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

What Is Gender

October 10, 2017October 10, 2017

Gender is confusing. It’s often used and understood as a synonym for sexual genitalia. Consult any dictionary, and you’ll see. And while, in our culture, both terms are inextricably linked with one another, they are different. They’re associations with one another (and our staunch adherence to them) have proven oppressive and dangerously limiting.

For some, it’s never an issue; they’re born, they are raised as the sex they were assigned at birth, identify with that sex and its associated gender, and it’s all good. For many others, it’s not so easy. Some of us feel confined by the limits of our current conceptualization of gender upon which our society has agreed and enforced for generations.

Even in places where people self-describe as open-minded and accepting, a cis man wearing a dress is assumed to be in costume, and a femme or high femme woman with fully grown out leg hair is a spectacle.

Gender is a construct, and we have agreed that being masculine means one thing and being feminine means another. Many of us who disagree with this construct do so while following the rules. We feel that we are following these rules against our wills. When people do break free and live authentically, however outside the norm, they are mocked, isolated, bullied, attacked, and even killed.

For years, in the Trans community, “passing” has been a goal. Some want to pass in hopes of feeling in alignment with who they know themselves to be. Some want to pass to look and feel like and be accepted as a “real” man or woman. (Please note that I am absolutely simplifying this concept.) This is a testament to the generations of patriarchy, toxic masculinity, sexism, and misogyny that inform our culture. Men must “look like men, ” and women must “look like women.” To this day it’s still an issue of safety as MTF (male-to-female) people are the most targeted members of our community. (And MTF People of Color make up a substantial portion of that group.)

Obviously, this is not true for every Trans person. There are plenty of people in the Trans community for whom passing isn’t much of a goal, and there are many who’ve found more peace and happiness after transitioning. Happiness is a universal goal, and many eventually find it after they have transitioned. (Most people don’t find immediate fulfillment; transitioning is often a long and arduous process during which a person can face various types of rejection and self-doubt. Years of managing the stress brought on by denying oneself, living in fear of being rejected for living authentically compounded by the stress of letting go and allowing oneself to transition is an enormous undertaking.)

But there is a whole group of people who identify as Trans and don’t want HRT (Hormone Replacement Therapy) or surgeries. Some Trans people want HRT but not surgery. Some want some of the surgeries but not all and don’t want HRT. Some FTMs will never look the way we’ve been conditioned to identify as male, and some MTFs will never look the way we’ve been conditioned to identify as female. Most of us assume that when someone transitions they’ll start behaving and presenting in a way that our culture affirms as masculine enough or feminine enough.

We have decided what is masculine and feminine, which characteristics are ok to swap and which are definitely not ok. Straight men can have long hair, but they can’t wear makeup. Women can have buzz cuts and abstain from shaving body hair, but they’d better be Lesbian. Our culture puts an incredible amount of pressure on its members to conform to its rules and has assembled a loyal and persuasive army of militant enforcers who are always more than willing to defend these rules.

In response, so much dangerous adherence to these limits is the notion of being gender-fluid. Gender fluidity is gaining momentum. A lot of people don’t feel they should have to comply with a certain presentation based on their genitals. So they don’t. They identify and present however feels most authentic to them. They don’t ask for permission. They don’t appease. People who are gender-fluid have looked at the gender, and sexual constructs created by the dominant groups in our culture and have opted out. They are creating a safer, more inclusive culture where we are not defined by our presentations or ruled by binaries and either-or options.

I’m often asked about “detransitioning” and how common it is. This is a complicated subject and will take time and commitment to discuss. If you have any questions about what I’ve written or would like to discuss detransitioning, please contact me. I’d be more than happy to talk about this with you.

Love and Be Loved,
Natalie

How Do I Know If I Need Therapy?

October 2, 2017October 5, 2017

“So about how long should it take until I feel better?” “How long do you think I’ll need therapy?” “How many sessions should I expect to attend before my problem is solved?” I have asked all of these questions during time spent on the other side of the couch. I know what it’s like to want concrete answers and expectations met. Everyone wants a sure thing in the face of so much uncertainty.

Therapy is not exactly a sure thing. Surely, it can and does help, but it’s not as simple as basic input of time and results yielded. Results depend on client honesty (with themselves and the therapist), right fit with a therapist, client’s commitment to the work both in and out of the therapy office, and right fit with whatever therapeutic modality is used.

Therapy is almost never a quick fix, but there are quicker-fix type/brief therapeutic modalities available. Whether or not these protocols are right for someone depends on a lot- personality, history, diagnosis, whether or not a person has experienced complex trauma. Even in the best of scenarios, it still requires the practice of skills through time to maintain results.

Under the psychotherapy umbrella, there are five really (really) broad categories we use to organize treatment strategies:

Psychoanalysis and Psychodynamic Therapy:

Makes the unconscious conscious, insight oriented. Emphasis on client-therapist relationship. Brief therapy model (20 session maximum) is not the rule, but is available for single-incident trauma like an attack, rape, catastrophic event, targeting a single life shift.

Examples of Psychodynamic Therapy: Jungian, Dream Work, Attachment-based

Often used for: Increasing self-compassion, improving self-concept, self-actualization, mood disorders, relational problems, trauma, developing insight to identify and manage internal conflict, shifting external locus of control to internal locus of control, couples, families,

*Psychoanalysis: Multiple times per week. The therapist is a blank slate onto which client projects their beliefs and experiences. Relies heavily on free association.

Behavior Therapy:

Focuses on conditioning new behavior. Uses brief therapy model.

Examples: Applied Behavioral Analysis, Aversion Therapy, System Desensitization

Often used for: Phobias, Addiction, Anger issues, Impulse control problems, self-injury

Cognitive Therapy:

Focuses on changing thought pattern. Uses brief therapy model.

Examples: Rational Emotive Behavioral Therapy, Cognitive Behavioral Therapy

Often used for: Phobias, Addiction, Schizophrenia, Bipolar Disorder, Suicidal ideation, Anxiety disorders

Humanistic Therapy:

Focuses on cultivating personal accountability and reaching highest potential. Emphasis on free will. Uses both brief and long-term therapy models.

Examples: Gestalt, Client-Centered, Transpersonal, Solution-Focused, Adlerian

Often used for: Improving self-concept, self-actualization, improving communication with others, cultivating self-awareness, shifting external locus of control to internal locus of control, couples, families, existential crises

Integrative or Holistic Therapy:

Often referred to as “Eclectic Therapy.” (Some practitioners will basically fight to the death in disagreement over whether or not Integrative is also Eclectic.) Uses various modalities depending on what is indicated for each client. One therapeutic modality combines various features of the previous four categories. Uses both brief and long-term therapy models.

Examples: EMDR, Narrative, Cognitive Behavioral, Dialectical Behavior, Internal Family Systems, Gottman Method, Transactional Analysis

Often used for: All of the above

Some people prefer to see the same therapist for various issues they’d like to target while others seek out a different specialist to treat each issue. There’s no right way to do this, just whatever feels like it’s working for the client. Some clients come with an agenda and leave when their goals have been reached. Some stay for a while after because they like having a professional to talk to who’s all about them. Plenty of people try therapy and find it difficult to give themselves over to the process, take a more passive route to treatment, get frustrated and give up. Sometimes this is because traditional psychotherapy is not a good fit for them right now, maybe ever. There are so many other great therapeutic options. Traditional psychotherapy is not the only way to heal or feel better.

I know it’s overwhelming to look for a therapist and decide which kind of therapy would be best for you, especially when you’ve been dealing with a problem for years, and you’ve finally decided to take the plunge and ask for help.

If you describe the issue and a little bit about yourself, many of us will be able to direct you in the right direction. There are plenty of therapists who won’t do this because they are sure that they can handle it regardless of their training and orientation. While I would like to believe that this is mostly the exception rather than the rule, it happens. If you feel too overwhelmed or busy or exhausted to educate yourself on various therapeutic tools and modalities, remember that you can interview multiple therapists at a time to see who feels like the best fit for you. (You can also do this regardless of your stamina to self-educate.) Once you start seeing a therapist, you can audition us. If you’re not feelin’ it for some reason, you can switch. It’s ok not to like your therapist or to like them, but feel like they’re not actually helping you. Therapy is an investment, and you have the right to switch providers at any time for any reason. If you’re feeling like you need to discontinue treatment, I usually recommend addressing this with the therapist; sometimes it just takes a little direct communication to shift things. Even if you don’t plan on continuing your work with the therapist, honest feedback is good for both sides.

If you’d like to talk more about this, please email me or call and I would be happy to answer any questions. This is one of my favorite subjects!

Love and Be Loved,
Natalie

If You Say So…

April 18, 2017April 20, 2017

When I was past the fledging-therapist stage, but not yet a seasoned professional (so, maybe the adolescent-therapist stage), I was talking with my mentor about a clinical struggle I was having. I was really going through it. This is the day that he told me about the “If you say so” approach to life. The idea is pretty much “you are what you think,” but with more of an emphasis on personal accountability. He hadn’t said much about it when I had already decided that I hated it and that he was totally wrong. I remember fighting him pretty hard on it and trying to get him to validate that actually; I needed an easier, softer approach. He said, “Soft, yes. Easy, no.”

The “If you say so” teaching is easily described as this: the more energy we spend thinking about something, the more of a belief it becomes and the more probable the outcome of its nature. So, if I spend a lot of time thinking, “I can’t mess this up. It would be a disaster. I can’t. mess this. up!!” then, eventually I’ll believe that I really can’t mess whatever it is up because it would be a disaster. The more I believe it, the more pressure I put on myself and the higher the likelihood that I will make a mistake (“mess this up”) because I’m operating in panic or anticipatory anxiety mode. It’s not just about the words, but the feeling behind them. When we’re thinking these thoughts, we’re often feeling/sending ourselves the feeling of fear, dread, threat, or criticism.

I hated this approach so much when my mentor first told me about it because I didn’t like the idea that my outcome was my responsibility. I was coming out of a “, but life just happens to me!” phase and although it wasn’t serving me anymore, I was still seeking validation that it could. He wasn’t having any of that, though, so he continued to carry the accountability torch. For months we talked about the truth behind the fact that if we think something enough, we’ll believe it and it will manifest in our life situations. I staunchly defended against it, tried to poke holes in it, anything. Luckily, I failed.

After many (m a n y) conversations about it and the eventual incorporation of the practice into my own life, I began to experience the beauty of “If you say so.” I also realized that my mentor was teaching me to hold myself accountable for my choices of thought and responses in an incredibly self-compassionate way. He never used those exact words (it was something more like “show up for yourself” or something), but knowing what I know now, it’s clear that he was teaching me to cultivate self-compassion.

It was the “showing up for myself” or self-compassion that really made me adopt the belief that “If I say so,” it’s true. I looked back at all the negative self-beliefs I’d held and made clear associations between my negative thoughts that I’d turned into negative beliefs which turned into real things and situations. Since I had been paying attention to my thoughts and choosing them more deliberately, I was also able to see how I had turned my positive thoughts into positive beliefs which turned into real things and situations. For the first time, I felt empowered. I could decide how I was going to feel. I could decide what my experience was going to be like. I could decide how to respond to something, how much to personalize something, how much to let something go. It was my decision whether I was going to let a rude comment or a mistake or a scary situation ruin my day or week. I knew for the first time that I could let feelings and situations inform me and then let the rest go.

Research has confirmed that self-criticism and negative self-beliefs directly impact behavior, achievable outcomes, and self-efficacy in a negative way. Research has also confirmed that self-compassion and positive self-beliefs directly impact behavior, achievable outcomes, and self-efficacy in a positive way. The power in that is crazy!!!

Sometimes a lot has to happen before we feel ready to just switch our way of thinking. I get that; this was also true for me. I’d be happy to talk with you about what next steps would be helpful.

Give it a try first-

Right now, give yourself two minutes to observe your thoughts. If you’re having trouble and you need to jumpstart your thoughts (which almost never happens because they’re so good at flowing on their own except when you suddenly shine a spotlight on them), think about some of your goals or what’s important to you. Some people notice emotions or sensations in their body before they notice their thoughts. If this is you, then observe these feelings and sensations and notice the thoughts with which they’re associated. Do these thoughts, feelings, and sensations feel like a new experience to you or do they feel more familiar? Which beliefs have they fed? And finally, notice how these beliefs have demonstrated themselves in your life through your behavior, through a pattern, or through life situations.

The more we realize we really do have the power to create what we want to see in life, the more freedom we get to experience. (But again, I get it. At first, it’s like, “What the hell are you talking about? Shut up. Do you really think that if it were up to me, I’d have created this kind of life for myself?!”)

Love and Be Loved,
Natalie

Take Some Space

March 21, 2017March 22, 2017

“Between the stimulus and the response there is a space, and in this space lies our power and our freedom.”
-Victor Frankl

We have so many goals and desires. We want to engage in purposeful, fulfilling work. We want to have enriching relationships. We want to be healthy, financially secure and loved. We want a lot out of life, but we don’t always allow ourselves to achieve it. Frequently, I talk about why we might block ourselves from accomplishing our goals, and today I’m going to talk about how we block ourselves.

And no one wants to hear about the ways in which we get in our own ways or things we do and think to sabotage ourselves. Most people don’t like to think about our part in unpleasant experiences. We like to blame it on other people, things, past experiences. Most of us find personal accountability pretty challenging.

Speaking for myself, I can say confidently that two things are true about myself: 1) I’ve set goals and 2) I have worked really hard to resist making space for myself to achieve those goals. Most of us do it with something. It’s not conscious. We think we’re fighting our hardest and fiercest to get what we want. And we are fighting, vigorously and ferociously. We just aren’t always fighting for ourselves; we are fighting ourselves, everything we don’t want (and sometimes, everything we do want). We get too handsy with the goal don’t allow for what we want to be a part of our narratives. We want to reach our goals, but we fight them.

I’ve heard stories like this from clients and friends for many years. We want something; we go after it, but somehow we end up creating an even bigger challenge. We get frustrated. Sometimes we give up and walk away. And resistance can be so sneaky. It can totally appear to us that we are taking steps toward our goals. But, then why do we feel further away from accomplishing them than when we started?

Take this common problem: “We’re not getting along.” Ok, I get it. We’ve all been there. We’re figuring out an issue with a partner, trying to see eye-to-eye on something, effect some compromise, maybe but it just… isn’t happening. We start talking about it, disagree, fight, and someone either blows up or walks way. (Sometimes both, am I right?) And we think, “But I’m trying to talk about it. I’m trying to help us reach an understanding. Why isn’t it working?” Sometimes it’s not working because we’re not allowing for the change. We’re not making room in our relationship or our communication style to allow anything different to happen. Instead, we are suffocating the possibility for change with a closed mind and heart, forceful confrontation, and poor emotion management. This approach resists the very change we want to see.

When I first started my private practice, I knew that I needed an office to see clients, but I didn’t have any clients, so I wasn’t sure how I was going to pay my office rent. But if I never got an office, how could I see people? And I would just go around and around like that, sometimes for days at a time. Intellectually, I knew it would work out, but my fear wasn’t so sure about it. Eventually, I took the plunge and experienced the change I wanted to see. If I had never made space for this change, I probably would have given up a long time ago. Sure, there were obvious actionable steps I had to take in getting there, but first I had to allow for this thing I wanted by making space for it.

We have to make space to allow for the changes we want to take place. It’s true for any of these pretty common concerns:

“They don’t appreciate me.”

“I can’t lose weight.”

“I’ll never save enough money.”

“How long will it take until I feel better?”

“My life is one big clusterfuck.”

“I’m always so stressed out.”

If you’re finding that you feel you’ve been fighting for what you want and seeing low to no results, try this:

Step 0: Look into starting a mindfulness practice (get acquainted with how space feels)

Step 1: Step back from the situation (make space for yourself)

Step 2: Look at your situation (make space for possibility)

Step 3: Ask yourself if you’re forcing an outcome (more space)

Step 4: Extend compassion for how hard it is not to force an outcome (compassionate space)

Step 5: Be interested in other possible responses to your frustration and feelings (constructive space)

Step 6: Try some of them (adventurous space!)

Step 7: See what happens (curious space)

Sometimes we have to have a knock-down-drag-out fight for what we want. Sometimes we just have to allow space for it to be.

Love and Be Loved,
Natalie

Post-Election 2016

November 14, 2016November 20, 2016

The U.S. General Election of 2016 has been stressful for most and torture for many. The months leading up to the disastrous outcome supplied us with vitriolic arguments and constant contention. Some of us have been directly impacted by the state of affairs our nation for years, for generations while others are just now feeling the fire, post-election. Some of us were shocked, others are not surprised but disappointed. Postings on social media and articles in major news publications have called this election divisive. They’re right. But the divisiveness and division plagued our communities for generations.

We’ve always been stronger together and now is as good a time as any to exercise this strength. It’s easy to let our feelings dominate us and react, especially when people’s safety is at risk. And it’s easy to get defensive. Some people deal with this by avoiding all information and actively disengaging from the issues. Others inundate themselves with information, mobilize, and march for justice. Some people are relieved Clinton lost. Others are devastated. Many felt that neither candidate was suitable. Let’s use this process as a way to learn how to be better with and for each other. Instead of avoiding conversations and each other, let’s use this to make us stronger, to help us see what else needs to be done, and to take responsibility for ourselves as part of the solution. Here are a few suggestions to stay grounded and connected to loved ones during this time:

Put your energy into action to ensure that you’re doing everything you can. If you’re angry and scared, find out how you can translate that energy into something that will make you feel productive and empowered. If you’re tired of fighting, rest and ask your network to hold your torch for a while.
Don’t get lost in self-blame if you didn’t vote, if you didn’t participate in activism or social justice activities, or if you don’t live your life in the margins. Instead, educate yourself on what next steps need to be taken and take them.
Don’t just apologize to your Muslim, POC, LGBQ, Trans, Undocumented, Migrant, Sexual Assault Survivor, Female friends. Ask what you can do to support them. Fight alongside them.
Have conversations about this with others if you feel up to it and give yourself permission to walk away if you don’t.
Remind yourself that it is not your job to take care of your friends’ feelings if they are experiencing white guilt, straight guilt, privileged group guilt, etc.
Donate your time, your energy, and your resources.
Keep talking. Be compassionately curious about other people’s experience. Ask questions and communicate with others about why they believe what they believe. This is to lay the groundwork for empathy and understanding. Both are critical in productive communication and soltution-finding. When we shut down and stop talking, stop listening, we cut ourselves off from finding workable solutions.
Educate others where you see a need for it. Much of the research has shown us that our nation is in this position of making hate/fear-fueled choices based on a severe lack of education and lack of exposure to diversity.
Respect others’ grieving processes and how they choose to express it. Be sensitive to their needs and experience. Everyone’s process is different.
Remember to engage your self-compassion. Check in with yourself and give yourself what you need as you become aware of it. When you need soothing or validation try repeating to yourself, “Even though I am feeling________________, I deeply and profoundly accept myself.” Self-compassion is a fundamental resource available to us.
Identify and surround yourself with whatever and whoever connects you to hope.

And please let me know if you need anything. I’m always here.

Love and Be Loved,
Natalie

There is Enough.

October 25, 2016October 25, 2016

Experiencing deprivation is painful. Whether we’ve experienced deprivation in a neglectful or abusive relationship, financially, or otherwise; the lived experience of “not enough” hurts. Even when we are no longer in that same situation where we experienced the deprivation we often find ourselves in the same mindset. We can be in a totally lucrative career, making plenty of money or in a healthy, stable relationship with plenty of love and affection and still feel like there’s “not enough.”

And that scarcity mindset is a harsh landscape. It prevents us from allowing ourselves to really enjoy what we have and keeps us stuck in fear of losing it. We want to feel gratitude and excitement for how far we’ve come and where we’re at now, but we won’t allow ourselves to experience it for fear of jinxing the whole thing.

I find that, for myself, whenever I’m coming from a scarcity mindset it feels so much more dangerous to take a risk, put myself out there and get what I want. I think to myself, “Don’t rock the boat, man. You’re lucky to have what you have.” It feels safer to hold back.

It can almost feel like we’re getting away with something when we find ourselves in a good place. Any second it could all come crashing down, and we’ll lose it only this time we’ll end up worse off because we know how much better life can be. We end up holding ourselves back. Some of us protested against the deprivation we experienced in the past and got burned. The person we wanted more from rejected or abandoned us. The boss we confronted fired us. It taught us that it really is too risky to rock the boat, that we should just shut up and take what we’re offered if we know what’s good for us. So we stay stuck. It makes us more fearful and resentful. Years pass and it feels like life is just happening to us.

Often, I post about a subject and then write about some helpful tips to try. I won’t do that this time. For some reason, it seems like it would be somehow misleading. There’s no quick fix for overcoming a scarcity mindset. (I mean, there’s no quick fix for anything.) It’s a process of very deliberate practice. Some might find strength in cultivating a mindfulness practice. Others will find it in a therapeutic relationship. Some might find it using a combination of tools.

I will encourage you to try this, though. See what it’s like to notice whatever it is you’re afraid of losing. Notice how much you like having it in your life, what it does for you, how it nurtures you. Whenever the panic shows up and tells you that these are the exact reasons you’re afraid of losing this aspect of your life, acknowledge it with compassion. Remind yourself again how grateful you are to have whatever it is at the focus if this exercise.

I’ll be honest. It will be hard at first, and you’ll freak out about losing whatever it is you’re afraid of losing. You’ll probably feel anxious and irritated. When I first started, I would think, “Whatever. This is stupid.” Sometimes I’d cry, filled with anxiety about losing what I loved. It’s fine. There is no right way. You’re only job is to notice that part of yourself with compassion and remind yourself of your gratitude. Maybe you’ll only feel like you can do it for a few seconds. That’s enough. Maybe you’ll be able to do it for a minute and a half. That’s enough, too. It’s enough because there is enough.

Love and Be Loved,
Natalie