Basics of Prioritizing

How often do you wish for more hours in a day? There is always so much to do. Another room to be cleaned, another deadline to be met. It never stops. 
Unfortunately, more time in the day would only make the problem worse. You would just take on more responsibility, expect more if yourself and others.
The only way to effectively have more time is to have less stuff to do. 
Answer this question: “If there were only 18 hours, how would my day be different?” What about 12 hours?
Those things you would be forced to put first are your priorities. Those are the things that matter to you.
Now, the real question is are those the things you want to be important?


Who likes “the process” of change?

No one.
The answer is no one.
Change is a huge, time consuming, emotionally draining process that everyone hates and no one wants to see.
We want a magic trick. We are all supposed to change and grow effortlessly and seamlessly. Whenever a problem arises, we are supposed to disappear into a cocoon somewhere and emerge perfectly transformed. This is true of so many things in life. 
Think about it. What does society, your family, or you expect? Poor people are supposed to just have money. Fat people are supposed to just be thin. Those with mental illness are supposed to just be fixed.
It’s an absurd standard and one that we should reject thoroughly. The process of change, especially purposeful change, takes a while and is very messy…but it’s a mess in which we should see beauty. 
We have to give others and ourselves time. We have to trust that they want to be happy and healthy. See absurd expectations for what they are and let yourself have your process. It is your right.


To be the last therapist

This article was supposed to be about how to be “the last therapist a client needs” but I have realized that there is no way to define that mystical creature.

Therapists always dream of being the last one. We want to be the one who solves the problems and helps healing happen. How many of my clients have seen multiple therapists over their lifetimes? How often do they have less than flattering things to say? I can’t tell you, except that the answer is most! (Of course, why would they becoming to see me if they had great feelings about their last therapist?)

Perhaps, the crux of the problem is in the mandate to be genuine. All therapists have a style and way of interacting. We can alter that to some degree and find ways to maintain unconditional positive regard. However, no particular style works for all clients. If you want to be the last one for all clients, you are doomed to fail.

Being a therapist is often very emotionally difficult but so is being a client. Clients must expose deep emotions and dark secrets and the therapists must bear witness and provide healing. There is a vulnerability and a tension that exist between clients and therapists. Sometimes is provides a way to heal and sometimes it doesn’t.

I am desperately afraid of the “doesn’t”. I remember being a client that hated my therapists, at least as a child. It’s a strange irony that I went into the profession, for sure. My parents send me to therapists left and right, and I hated all of them.  The idea of being one of those therapists kills me.

 I am desperately afraid that I will somehow make things worse for a client; that I will unknowingly harm them because I miss an important context clue or do not conceptualize the problem correctly. Obviously, I continue my work. I stay educated and get all of the proper supports. I do everything I can but that fear stays with me.

Research suggests that a therapists ability to apply an evidenced based therapy is the best predictor of client improvement but the best therapies still only have a have a success rate around 60%.  What about the other 40%? What makes the difference?  It’s those clients that I have been and am so interested in. It’s those clients for whom we want to be the last therapists.

Clearly, this will continue to be a struggle for me and for other therapists until we have more research. Until then, let me ask you. Have you found your last therapist? What do you find helps you the most?



Mental Illness and the Cancer Analogy

It wasn’t that long ago that people would get mysterious wasting diseases. They’d lose vast amounts of weight, have no energy, fail to meet obligations, and eventually just die…all with no scientific explanation. Friends, family and society would judge the person harshly. They would say she had lost the will to live, was vain or was morally corrupt.

Today, we recognize these diseases as cancer.

Does this sound familiar? If it does, then you have likely suffered from depression, addiction, an eating disorder, or any other mental illness out there.

Those who suffer with mental illness are judged harshly; thought of as inferior in some way. Like those with cancer in the days before molecular biology, mental illness is not understood by the general public. 

Most people do not recognize it for what it truly is…a brain disorder, based in genetics and triggered by environment.

I’m not trying to say mental illness is untreatable or those who suffer should be given a pass on life. There is treatment out there and just like someone with cancer, treatment should be sought and encouraged.

What I am trying to get at here is that judgement is unfair and unnecessary. One day the general public will know that mental illness is biologically based and maybe the criticisms and judgements will be less harsh.

Until that day, stop being so hard on yourself, get the treatment you need and pass on some compassion to the next person.

What are some of the judgements you’ve faced? Do you have a message for others that suffer or those that judge?


Attitude of Gratititude

The phrase “Attitude of Gratitude” is one you hear used in the rooms of AA and other 12 step programs. Obviously, it refers to giving yourself an attitude adjustment when you get angry or resentful and remember all the good things you have in your life. Gratitude is also what the holidays are supposed to be all about! It seemed like an appropriate topic at this time of year.

Gratitude is a powerful way to up your mood or challenge abusive self-talk or even the black and white thinking that comes with addiction, depression, eating disorders, and just life in general.

Having an “Attitude of Gratitude” is especially useful at challenging perfectionist thinking. When you go days on end, feeling like you are not allowed to enjoy anything or that nothing is good enough, readjusting your thinking is a break from the unrelenting criticism and cruelty. Even if it’s only for a few moments, it’s quite nice, actually. 

Gratitude also helps you find reasons why recovery is worth it. Recovery is hard work and sometimes may not feel worth the effort. Gratitude allows you to reassess your priorities and refocus on recovery in those more difficult moments.

So, how is this done? Some people make gratitude lists, a set of 5-10 things they are grateful for in the morning or a specific day of the week. Others  find 1-3 things to be grateful for when they realize they are becoming resentful or angry. There is no right way to adjust your own attitude. You get to figure out what works for you!

Today, I am grateful for the moment when my son was playing and he looked up, saw me, yelled “Mama” and ran towards me for a big hug! I am grateful for the recovery that is allowing me to carry a second child. I am grateful that the shopping is done and I can rest for a moment.

What are you grateful for today? How do you maintain an “Attitude of Gratitude”?

Why we stay stuck: Part 5

As we move into the fourth and final way to understand why people stay stuck, psychologically speaking, we have to consider the totality of the human experience, as that is what spirituality is all about. We have moved from the biological aspects up through the interpersonal. Now we are moving onto the spiritual.

Spirituality is difficult concept to process and define, but I shall do my best. Please do not confuse the spiritual with the religious. Religion isn’t really suited for a discussion based in science. How does spirituality fit into the picture, then? “Casey,” you might be thinking, “I thought spirituality and science were antagonistic to each other.” Well, inherently, no, they are not antagonistic and most of us in the mental health field understand that spiritual health is an important facet of psychological health.

But let me back up. Let me see if I can define spirituality and how it relates to the idea of being stuck. Social scientists have come to see spirituality as the way a person sees herself and her experience in a broader ontological context. In other words, how do you believe your life fits into humanity and history as a whole. Victor Frankl, a Holocaust survivor and founder of logostherapy (“Meaning therapy”) wrote a book called “Man’s Search for Meaning,”1 and in it, describes how finding meaning in your life can allow you to live happily and move forward psychologically, even if your body is physically stuck. Meaning and purpose allow you to have hope, to see the positive aspects of a painful situation, and see the best in yourself.

When we find ourselves “stuck”, in the spiritual sense, we have lost our meaning in life or our understanding of our purpose has become distorted. Maybe cannot connect our personal experience to the whole of humanity or what there is a conflict in our values and what we think our purpose is. For example, if a person believes she does not matter as a person or that what she is doing with her life hurts others, she will have a difficult time being psychologically healthy. She may start to feel trapped in her own life. She may find herself stuck.

I think we’ve all had moments of being stuck in the spiritual sense. It’s certainly easy to see the trickle down effect on the rest of levels. Your relationships, thoughts and even your brain will suffer when you don’t feel like your life is worthwhile.

Hopefully, through these brief discussions on why we stay stuck, you can see how we find ourselves locked in depressed and anxious states. Maybe it’s because our brain have changed. Maybe it’s because we’re in a cycle. Or maybe it’s because we lack meaning and purpose in our lives.

The next question, of course, is how do we get out? How do we unstick ourselves and finally feel better. Well, stay tuned for the next post! We’ll cover the different ways you can intervene at all the different levels.

1 Frankl, V.E. (1985). Man’s search for meaning. New York City: Simon and Schuster, Inc.


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