therapy

When the Cause of a Sexless Relationship Is - Surprise! - the Man

The New York Times published a brillant essay from gynecologist Jen Gunter about sexless relationships and the implicit understanding that it's often the woman's fault. 

"Our society seems almost built on the erroneous idea that all men want sex all the timeso I imagine it would be hard for men to admit to a lower libido, even anonymously. I have lied about my weight on many forms. That doesn’t make me a broken person; it just proves that a cloak of invisibility doesn’t hide you from yourself. The most damaging lies are the ones we tell ourselves."

Relationship problems rarely get better on their own. Addressing sexual incompatibility in your relationship with a trusted therapist can be helpful in moving forward.

So, what is it you practice anyway? (Part 2)

This is the second part of a series on identifying the types of therapy I practice. Read Part 1 here.

What's the meaning of life? Why are we here? What's our purpose and passion? These are the kinds of questions I wanted to help people discover through therapy and turned to Existential therapy for framework.

Existential therapy is an optimistic approach that firmly believes in the human potential. It's a therapy that asks clients to confront and resolve conflicts of the human condition to live a meaningful and purposeful life. 

Irvin Yalom identified four themes or conflicts to the human condition: death, freedom (& responsibility), isolation, and meaningless. These four themes are the root of psychological problems and do not have real answers. They're used to conceptualize and address problems.

Death: Confronting the reality of death is a central pillar of Existential therapy. The goal is to encourage awareness of death with resources to not allow someone to become overwhelmed by it. Existential therapy works to identify denials of death through avoidance (afterlife, distancing), and/or uniqueness. "What would you do if you knew you were going to die tomorrow? How would you live differently?"

Freedom (& Responsibility): Freedom is choice, agency, and awareness of constructs. Existential freedom helps one understand the influences one has been subjected to and encourages taking ownership for thoughts and feelings. The responsibility that comes with freedom is acknowledging what one has done and recognizing defensive patterns. This is where change happens.

Isolation: Yalom identified three types of isolation. Interpersonal isolation is separation from oneself and others. Intrapersonal isolation is splitting oneself off from their relationships as to not be fully present. And existential isolation is the concept that we're never able to truly overcome our isolation, as it's part of the human condition. Understanding how and why we isolate is important to recognizing defensive and destructive patterns. 

Meaningless: Existential therapy maintains that humans are meaning seeking and/or meaning creating being, depending on your world view. I hold that to a degree both are true - life can be meaningless and we create meaning out of it. However, I also think there are aspects of life that have meaning, we're just seeking them out. It is in this theme we explore coping versus growing, and seek to help individuals move from just coping with perceived problems into growing and fully living.

Existential therapy believes that humans are essentially alone but long to be connected. Though we seek connection, our own validation must come from within. We cannot seek validation from others. 

Existential therapy is a powerful and deep framework I use to conceptualize some of life's greater problems. As a counterweight to CBT, it works well in identifying patterns and motivations, resolving life struggles, and dissecting the root of the problem.

So, what is it you practice anyways?

This first in a multi-part series exploring the types of therapy I practice.

I've been a big believer in Cognitive Behavioral Therapy (CBT) since studying it in graduate school. The simple premise behind CBT is that your thoughts influence your feelings, which influence your behavior. Understanding this pattern allow you to change it, right at the core.

Say you're in a meeting with your boss and she's not saying much. 'Is she annoyed with me?' you think. 'Maybe what I'm saying is totally off base.' These thoughts might make you anxious and start second guessing everything you're saying. These emotion-filled thoughts are called automatic thoughts, and they pop up based on beliefs about ourselves and the way the world works. Instead of automatically thinking your boss was annoyed, wondering if your boss was tired or preoccupied may change how you behave.

Automatic thoughts rely on perceptions about yourself and others called core beliefs. Core beliefs are developed from childhood experiences, cultural influences, your environment and more. Common core beliefs often follow themes of abandonment, un-lovability, defectiveness, helplessness, and entitlement.   

I have to be in control to be ok.

I'm unsuccessful.

If I don't succeed, I am worthless.

It's not ok to ask for help.

I'm stupid.

I'm bound to be rejected.

Challenging these automatic thoughts is the key to accessing and changing these core beliefs. Asking yourself questions like "Am I jumping to conclusions?" or "Am I condemning myself as a total person based on a single event?" or "Am I using all-or-nothing thinking?" can help challenge these thoughts. 

Noticing these automatic thoughts and changing them to a more realistic view can relieve distress. Changing the thought pattern from 'My boss is thinks I've done a terrible job; I'm worthless' to 'She's had a busy day and isn't saying much; Can I ask for feedback?' will change your behavior.

CBT is effective in treating:

  • alcohol use and abuse
  • substance abuse
  • depression
  • anxiety
  • chronic pain
  • chronic fatigue
  • eating problems
  • health problems
  • relationship problems
  • sleep problems

It's a short-term, problem-focused therapy that aims to systematically change the way you think about yourself and the world. 

Exercise can help emotion regulation

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New research suggests that aerobic exercise can aid in emotion regulation.

Harvard University researchers measured the amount of change a moderate amount of exercise had on emotional responses to an upsetting film clip in study participants. They found that the clip produced a negative emotional response in all participants, but those who'd participated in exercise before watching it were able to recover more quickly than those who hadn't.

Additionally, participants who exercised reported feeling less sadness than those who hadn't.

Healthy living has always included recommendations for exercise, and this new research seems to suggest the benefits extend beyond physical well-being.

Wise Mind

Wise mind, a Dialectical Behavior Therapy concept, asks us to become aware of our different mind states. Finding your Wise Mind, that midpoint between acting emotionally and rationally, becomes a powerful tool for navigating difficult life situations.

Intrinsic Motivation, or how to get yourself to do something

Motivation can be tough to come by. 

Watching a movie sounds so much better than doing the dishes. Going for a bike ride is way more fun than doing the project you brought home from work. Grabbing a beer with friends sounds so much better than taking the dog for a walk.

So how can you get yourself to do the things you're supposed to?

There are two types of motivation: extrinsic and intrinsic. Extrinsic motivation is when we're compelled to do something to avoid a punishment or earn a reward, like a child cleaning his room because he doesn't want to get grounded. Intrinsic motivation is doing something because it's personally rewarding, and it's the real key for finding and staying motivated.

So how do you tap into that intrinsic motivation? What's the secret to unlocking your potential?

It's simple, really. Focus on why you're doing things. Align them with your values (which may take a little more soul searching.) Pay attention to the moment. Keep your attention and awareness on the moment instead of allowing your mind to wander. And look for the enjoyable moments. Sure, doing the dishes may not be fun, but pay attention to how much better it feels to have a clean kitchen.

Relationship Activity Questionnaire

When relationships are in crisis, we often forget how or why attraction started in the first place. Use this worksheet to learn more about your partner, turning the focus temporarily away from problems.

"I'm not good enough"

It's been a common theme in sessions this week; this idea of not being good enough. I've heard from several clients,

"I'm tired of trying."

"I should be doing more."

"Why can't I just do [insert action]?"

The judgments flow freely and harshly. The comparisons to both real and imagined people keep clients stunted in the vicious cycle of inadequacy. Left unchecked, stuck inside our heads, this inner critic can paralyze us. 

"What can I do?" a client plead earlier this week, desperate for relief.

Focus on progress instead of perfection

Instead of focusing on your shortcomings, in what ways have you made improvements? What are the areas you'd like to change and how are you moving closer toward your goal? Focus on the positive.

Comparison is the thief of joy

The people you compare yourself to are probably comparing themselves to someone else, too. Measuring yourself against others is the surest way to limiting your sense of worth. Everyone's journey is different; there's no better or worse.

You can't hate your way into success

Motivational posters don't say "suck it up," or "gosh why are you so awful?" Telling yourself you aren't worthy or lovable won't make you more worthy or lovable. 

You are enough just as you are.

G.L.A.D. - A simple mindfulness exercise

Incorporating mindfulness into your daily life doesn't have to take much time. This simple exercise takes less than 5 minutes and provides an opportunity for reflection, something we often forget to do.

G.L.A.D.

In a journal, reflect on the following:

G: Write one thing you're grateful for. It could be basic, like the shoes on your feet or the bed you can sleep on, or it can be a meaningful relationship in your life. 

I'm grateful for my dog, as she provides me entertainment and company.

L: Write one thing you learned today. It can be something you learned about yourself, about how you relate to the world, or a new skill or piece of information you discovered.

I learned I do my best work when my office is in order.

A: Write one thing you accomplished today. This is a small accomplishment (unless you have a big one to celebrate), but is a simple reminder of the things you do every day. 

  • getting out of bed
  • getting enough sleep
  • paying all my bills on time
  • making it to work on time
  • completed all my domestic chores

D: Write one thing that delighted you today. These are things that made you smile or laugh, things that entertained you, or simply made you happy.

I was delighted by the Youtube video I watched today, which made me laugh. 

Set yourself a reminder and practice this exercise everyday for a week. Notice how you feel during and after this exercise.

Humans of New York on Anxiety

A brilliant post about anxiety from the Human of New York:

“I knew a girl in high school that always complained about having anxiety. I used to make fun of her a little bit. It looked like nothing to me. So I assumed it was nothing. And I dealt with it by trying to convince her that it was nothing. I called her recently to apologize. I’ve had really bad anxiety ever since my father died. And it’s definitely not nothing. It’s the indescribable fear of nothing.”

What I'm Reading

There's never a shortage of great reading material on mental health. I recently stopped at the store to pick up a couple things:

Buddha's Brain: The Practical Neuroscience of Happiness, Love & Wisdom by Rick Hanson. A great read on how contemplative practice can help harness your mind to cultivate happiness, love, and wisdom.

And Baby Makes Three: The Six-Step Plan for Preserving Marital Intimacy and Rekindling Romance after Baby Arrives by relationship expert John Gottman. Relationship satisfaction plummets after the arrival of the first child, and Gottman offers six steps to keeping the relationship spark alive during the most difficult first months of a child's life.

The Mindful Way Through Depression: Freeing Yourself from Chronic Unhappiness by Mark Williams, John Teasdale, Zindel Segal, and Jon Kabat-Zinn. Introducing practices of mindfulness and cognitive behavioral therapy, four experts provide meditations and tools to sit with uncomfortable feelings. It's not just "thinking your way" out of depression, but developing a practice that works. 

Drink: The Intimate Relationship Between Women and Alcohol by Ann Dowsett Johnston. Part memoir, part journalistic investigation, Drink explores contemporary trends with women's relationship to alcohol. 

The Gifts of Imperfection: Let Go of Who You Think You're Supposed to be and Embrace Who You Are by shame expert Brene Brown. Brown offers ten guideposts challenging us to change our thinking from "What will people think?" to "I am enough."

Hope and Other Luxuries: A Mother's Life With A Daughter's Anorexia by Clare B. Dunkle. A memoir about a mother's struggle with her daughter's anorexia. Too often we're consumed with focus on the individual struggling with illness, but the entire family suffers.