Recovery celebrates the gains people will experience when they let go of their addiction.
Improved health, restored dignity, healed relationships -- the gifts of recovery are innumerable,
and each day of abstinence brings even more peace and possibility to the addict’s life. Rarely,
though, do we acknowledge that recovery is marked as well by deep and profound loss.

Hidden Losses
Clients in recovery must say goodbye to habits, places and people that may have been the most
important parts of their lives for years, even decades. Many report that their drug of choice was
their “best friend”, the only constant source of support and relief they may have felt they had.
They can no longer spend time in the places they frequented when they were using; their using
crowd can no longer be the folks they count as their closest intimates. Even letting go of the
routines that accompanied their addiction -- the sound of the lighter against their cigarette, the
ritual of sharing drugs that accompanied most social gatherings -- are losses that may haunt
recovering addicts for months, even years. Despite the countless benefits people will
experience from choosing abstinence, their sadness and grief is as real and valid. Allowing
recovering addicts to own, feel and speak about their losses communicates an understanding
that change, no matter how positive, is always accompanied by e ndings. In this new beginning
of sobriety, people need to know that they have the right to grieve what they are leaving behind.
Despite the “friend” of addiction being an eventual killer, addicts often feel wistful about this
necessary cutoff. Embracing recovery means bidding farewell to meaningful touchstones of the
past, in order to enjoy the promises of a sober future.

Making Room for Grief 

Grief can stop time. We can be brought to our knees, unable to believe we will ever move beyond the gaping hole of loss that has forever changed the landscape of our lives. Enduring profound loss is one of the most painful of human experiences. But almost as excruciating is being witness to the grief of someone we love.

Healing Their Hurts 

When we love someone, we want to protect and shelter them from pain. We try to heal their hurt, or, even better, keep them from being wounded in the first place. But our instincts can be misguided, even hurtful, if we truncate the course of someone’s grief process. Rather than easing their pain, attempting to curtail grief can create a sense of minimizing the loss. People who don't feel they have the right or “permission” to grieve as deeply or for as long as they need to report feeling shame and guilt, and experience anger and resentment toward those who may have communicated that their grief is unwarranted. Even the best intentions -- an attempt to encourage a grieving person to “forget” their loss or to imply that the loss is “for the best” -- can cause deep pain and confusion. People who've lost a loved one, a job, even a coveted dream, most need validation. They need to hear that their feelings are valid, real and deserved. We must communicate that they have every right to their sorrow, to express it in ways that feel right for them, and that grief has no prescribed end date. Grieving people need to know we will remember with them, not push them to forget. Paying witness to another’s grief can be a powerful gift of intimacy and healing, confirming the value of the lost person, relationship or experience, and reminding us all of the preciousness of time and connection.

Love>Fear

I started my morning in a muddled daze, having spent a sleepless night tracking the results of the presidential election. Considering the outcome, I'd expected to respond to the reality with a sense of outrage, of fear, of concern for all the potential changes that await our country and that, in large part, remain unknown and untested. But as I moved into the first hours of the day, I found myself feeling strangely calm, almost at peace, in the face of more questions than I had answers. Where was this peace coming from? How could I feel sadness and grief, unhappiness with the election results, but still be able to observe a larger sense of quiet and contemplation that was larger than I am? When I allowed myself the space to analyze my response with critical awareness, I realized that the sense of calm I felt was coming from a sense beyond my feelings: I was responding from a place of faith. Not faith in the,religious sense of the world, necessarily, but from a choice to believe in what I have always thought true. Namely, in the ultimate innate goodness of humanity as a whole. In the benevolence of the universe. That everything comes full circle, and that, cliche as it may seem, this, too, will pass. As I believe in the constancy of nature, of fall following summer, I continue to believe that my only true movement forward is to embrace that faith that all will be well. That love is bigger than hate. And that love is a choice that is always available to me. I don't know if tomorrow I will awaken with that same sense of possibility and, dare I say, hopefulness. But I know I can count on the option to choose love. I hope, with all my mind and all my spirit, that love is the courageous risk we are all willing to take.

Shirking the Stigma of Mental Illness

Even after more than 20 years in the mental health field, I continue to hear stories of clients stigmatized by the inappropriate use of psychiatric diagnosis, of people waiting years, even decades, before seeking treatment. Some of my clients have hidden the fact that they are in therapy from their family members. Despite the gains we have made as a culture to dispel the negative stereotypes of mental illness and seeking treatment, many people still fear being judged as "weak," "crazy" or "incompetent" for pursuing counseling and/or medications to treat and help alleviate their symptoms, when in fact, resilience and strength are the real core characteristics of individuals brave enough to seek help when they are feeling their worst. I am familiar with the internal struggle clients experience when they must push against these unfair judgements, because I carried those judgments against myself years ago when I was first diagnosed with postpartum depression and prescribed anti-depressants. I'd already been in the social work field for several years, and was regularly attending therapy, which I considered a kind of "weekly visit to the gym" for my psyche and spirit. But after the birth of my son, a crushing depression characterized by nearly ceaseless crying spells, paralyzing self-doubt and a sense of hopelessness about the future frightened me enough to ask my doctor for a psychiatric referral. I was lucky -- I was quickly assessed by a competent physician, prescribed medication that I tolerated well and found helpful in lifting my mood, lightening the darkness that seemed to be clouding my life and provided me with a more realistic perspective on my life and this new chapter in it. I quickly returned to my "normal" level of functioning, and realized that I had likely suffered from a mild depression for as long as I could remember, including throughout childhood. The range of mood, positive outlook and hopefulness I felt once my medication was properly dosed were experiences I'd never had before. I continued to see clients and work with adolescents and adults with a range of life challenges. But my experience with depression -- and even more significantly, with psychiatric treatment and medication management -- offered me a level of empathy and understanding that increased my skills as a clinician. Years passed before I was brave enough to share my diagnosis amd treatment experience with clients. In many instances, it was a "game changer", as clients reported feeling like I "really  got" the totality of their experience.  But I also eventually realized that my depression is simply a thread in the cloth of my life, no bigger or more important than the threads I call "book lover", "amateur chef", "devoted mother", or "unapologetic disco fan." My depression is not a flaw, weakness or shameful secret. It's simply part of me, and likely always will be, like my brown eyes or love of crime novels. When I could embrace all the parts of me, my life and experience without judgement or labeling, I knew I could authentically encourage clients to do the same. We still have a ways to go to see mental illness as we do cancer or diabetes: as a medical condition that occurs irregardless of the character of the patient, and as worthy of effective, timely treatment and compassionate, supportive care. We would never blame a cancer patient for their disease, but rather celebrate their strengths in the face of a debilitating illness and unknown treatment outcomes. I look forward to the time when we approach people living with illnesses like depression, bipolar disorder and schizophrenia with the same empathy, compassion and admiration.

Say What You Gotta Say

Communication issues are a core reason people seek therapy. Whether couples seek counseling to learn how to resolve conflicts or individuals desire to learn assertive, effective ways to share their feelings, therapy can help people develop the skills to speak their truth. But often clients will say, "it won't matter what I say. They won't listen to me." But being heard is not the only endgame of speaking our truth.

Truth Connects Us 

We cannot control whether people listen to what we say. Whether or not people do what we want or respond favorably to our requests, our feelings and opinions still deserve to be aired. Not because we can guarantee the end result, but because we respect ourselves and the other. We demonstrate respect for ourselves when we give our feelings the weight they deserve. With our expression of our thoughts and feelings, we show  others that we respect them enough to be honest and authentic. We become empowered when we resist censoring ourselves. Our courage to be authentic gives others the encouragement to be as real themselves, With genuine conversation, truth-sharing and empathetic expression of our wants and needs, we gain more than being heard, even more than getting the response we want. We develop shared respect, deeper understandings and genuine connections.

"It Is What It Is" -- But IS It?

First used in sociology, the concept of social construction pertains to the ways social phenomena are created, institutionalized and made into tradition by humans. In more everyday language, we name objects, customs and behaviors based on how we see their functions in relation to our times. For example, we see a ballpoint pen and think "a writing instrument." But to our ancestors thousands of years ago, the slim, cylindrical object might be used as a tool to dig in the dirt before planting seeds, or as a "drumstick" to create rhythms when struck against a hollow gourd. Similarly, in modern times, aboriginal people of the rain forest would be unlikely to need an ink pen in their nature-based lives. How we use things guides us in naming them, as does where we are in history. Now, apply this idea to the labels we speak and think everyday. Man. Woman. Teenager. Success. Health. Goodness. Work. Play. Marriage. How do we define what makes up our world? Does the meaning of these words change across cultures, or even within our own lives, as we grow and change? Do we assume everyone uses these labels to mean the same things? By questioning the meaning, appropriateness and effectiveness of our morals, expectations and social rules, we allow for the evolution of greater understanding and compassion to occur. When we pause to explore whether an idea or custom still serves us, we enact the freedom that allows us to embrace new possibilities. Some things in life may remain unchangeable: gravity, nighttime following day, carbon as the basis of human life. But so much that we believe just "is", in reality, is what we choose to call it and how we choose to see it in this moment in time. What is more accurately could be called what could be. 

The Extraordinariness of the Ordinary

"Our culture is quick to dismiss quiet, ordinary, hardworking men and women. In many instances, we equate ordinary with boring or, even more dangerous, ordinary has become synonymous with meaningless." -- Brene Brown, I Thought It Was Just Me (But It Isn't) 

As I near my 50th birthday, I'm aware that many of us at the midline of our lives become reflective of our journey thus far, while also looking ahead to whatever achievements or dreams we still plan to pursue. I'm finding, however, that the future I look forward to will be marked, I'm hoping, with "smaller" moments, a slower pace, a focus much more on "being" than "doing." And this thought jars me, at least initally. In my first few decades, ambition and material comfort and building a family and a career kept me moving, always anticipating the next necessary step to achieve my goals. I gained esteem and competency by acknowledging my efforts and their impact, and by making the most of the "big" moments in my life (i.e., graduations, marriage, a promotion, having children.) And yet, those milestones were hardly extraordinary, and I found they rarely defined or sustained me for long. I know I'll never be famous, or cure cancer, or run a sub-four-minute mile. My face will never grace currency, nor will my name be recorded in any history books. But I've discovered the "ordinariness" of my life's days are graced with such wonder and bounty that I can't imagine any material honor could rival. And I want more of "those" kinds of days. The days of enjoying languorous sunsets; of my elderly dog's soft muzzle -- and even softer eyes -- settled comfortably in my lap. The meals I love cooking, filled with colors and aromas and shared with the people who matter. The softness of my beloved's neck, or the achingly sweet sound of my near-grown son snoring softly in the next room. No longer do I believe my life has to be unique or exemplary or "larger-than-life" to be worthy, important -- to be overflowing with meaning. I know now that contained in every "ordinary" moment is the totality of magic that makes all life truly a miracle. 

The Stranger Among Us

Our family is about to wrap up our last college visit this weekend. Our son is polishing his college applications and researching potential scholarship opportunities. For the most part, our venture into the college search has been marked with open communication, shared excitement and anticipation of the new experiences ahead for my son as he launches into his next phase of life. But most recently, my usually affectionate, talkative, connected kid has shown us a different persona -- curt, isolated, ripe with comments like "I can't wait till I'm OUT of here!", and "You won't know ANYTHING I'm doing when I'm away at school!" Wait...what???

The Push and Pull of Separation 

Luckily, my sanity -- and training -- kicked in relatively quickly. After I reigned in my carastrophic thinking ("Is he doing drugs? I know it, the last time he'll speak to me is when I drop him off at college! Doesn't he realize I'm the COOL mom?? We'll see how he likes being grounded until graduation!!") I realized my son is doing exactly what he's supposed to be doing: he's separating. The developmental task of separation/individuation happens to allow children to discover who they are in relation to where and who they came from. This phase can include rebellious behavior, exploration of new or alternate values and interests, and a greater investment in peer relationships over family. When an adolescent pulls away from family influences and moves toward new experiences, people and ideas, he is building the "muscles" of self-identification. I thought back to myself in high school -- my shaved head, punk rock preferences and surly posturing were no doubt concerning to my parents. But, like most people, I mirrored most of my family of origin's values and belief systems once I fully arrived in adulthood. And I am fully aware that my son's pushback is mild compared to the challenges many parents face with acting out adolescents. My greatest hope for my son has always been that he believe enough in himself to launch into the world with authenticity and confidence. If the cost of that is a few eye rolls, exaggerated sighs and reminders of just how "uncool" my rules and requests are, I'm willing to pay that price. 

ADHD -- It's Not Child's Play

Often first diagnosed in childhood, Attention-Deficit/Hyperactivity Disorder (ADHD) is a condition that often lasts into adulthood. Symptoms of inattention or restlessness may appear in both kids and adults, but adults with ADHD may exhibit a very different presentation than what most people think of when they hear the term "ADHD." Due to maturity and a lifetime of social conditioning, adults may not be "bouncing off the walls", but instead may struggle with inability to focus, low frustration tolerance, forgetfulness and disorganization. Relationship and social problems may haunt these adults, as those they interact with may mistakenly ascribe their distractility or lack of follow through as being indications of disinterest or unwillingness to be accountable in the relationship. Adults with ADHD may be able to tolerate the frustrations they experience at work, but decompensate in the "safe zone" of their home or intimate relationship. Thrill-seeking behaviors, substance abuse, contact with law enforcement and overspending are not necessarily emblematic of character deficits. Rather, for adults with ADHD, these acting-out behaviors may have developed initially as coping skills to manage frustrations or their need for stimulation. If you or a loved one was diagnosed and treated for ADHD as a child and are experiencing some of these symptoms, pursue an evaluation with a therapist or psychiatrist trained in diagnosing attentional difficulties. And since some individuals learned to compensate exceedingly well in childhood, many adults with ADHD go undiagnosed for decades, suffering unnecessarily the stress, low self-esteem and vulnerability that accompanies this disorder. Treatment may include medication, executive skills coaching, neurofeedback, and brain training via computerized teaching tools. ADHD is highly treatable, and the creativity, intelligence and resourcefulness of many of these individuals can easily surpass the deficits of the disorder if treated correctly.

Water, Water, Everywhere

On our recent family vacation to the beach, I experienced the intense feelings of relaxation and release that I get every time I'm near the ocean. The waves, the salty air, the damp sand between my toes -- I'm never as calm and centered as when I am near water. Perhaps it's the pull of our ancestors -- we come, ultimately, from the sea, and the human body remains anywhere between 85-50% water throughout our lifespans. According to different religions and cultures, water represents purity and fertility, an acknowledgement of our striving for truth and our urge to procreation. It symbolizes movement and transition, an understanding of the constant changes and growth that marks life. Water is used for blessing and sanctifying the beginnings and the ends of life. Water feeds our bodies and our souls. The next time you are near water, consider the ways it soothes, nurtures, moves and sustains you. As W.H. Auden wrote, "Thousands have lived without love, not one without water."

Go Gently

Take the gentle path. -- George Herbert

We celebrate achievement. We encourage effort, determination, "giving it the old college try." We are impressed when someone overcomes adversity, and we appreciate a good "coming-from-behind-to-win" upset. But what if true peace, accomplishment and esteem is best reached a gentler way?

Easy Does It

Being gentle with ourselves and others is not a manifestation of laziness or an indication we don't care. Rather, approaching our problems, efforts and relationships with care and quiet is a loving gesture, a stance that projects trust and hopefulness. Effort is not bad, but neither is waiting. Easing into change can be more productive than forcing. Forgiveness and gratitude provide healing and grace that anger and resentment cannot. Moving gently affords us the time to see and appreciate our environment, to let the wisdom around us seep into our bodies and our consciousness. Going gently, with awareness and openness, can bring us results steeped in the deepest layers of truth and allow us a stamina for more demanding aspects of life. Approaching life with gentleness can soften us, and others, providing a fertile landscape for growth and enlightenment. 

Beware the Anti-Mother!!

I can imagine the movie poster for the film about my life: a hideous, giant monster, with fangs and claws dripping blood, terrorizing the young children in her path with punishments, recriminations and selfishness. "Attack of the Anti-Mother!" the poster would proclaim. Kids would cover their eyes and other parents would simultaneously be outraged at my horrific parenting and grateful that their transgressions could never be as catastrophic as mine.

Growing into Motherhood 

While this description is (I hope) quite an exaggeration compared to the reality of my mothering, the truth is that I never really planned on being a parent. I wasn't one of those kids who enjoyed playing "house", or loved holding babies or couldn't wait to teach my offspring how to throw a ball or ride a bike. And my gag reflex is instantly triggered at any and all bodily fluids. I was somewhat bewildered at my lack of "mother lust" -- growing up I was more interested in books and writing than hanging out with kids my age, and as I grew older, I fantasized more about the kind of career I would have than how many kids would fill my house. I didn't especially enjoy being a child. Always a serious person, I was also acutely invested in justice from the youngest age, not a very productive stance for someone under 4 feet and lacking in all power whatsoever. When I did think about parenting, antiseptic images of family vacations and my kid's acceptance to Harvard dominated my vision. I avoided considering (YEARS. I meant it. YEARS.) sleep deprivation, before-school frantic rushing, learning disabilities, divorce. And of course, my life as a mom has included more harrowing, anxious, self-doubting experiences than the rest of my life combined. But, to my absolute surprise, it has been a part of my life that I have enjoyed, savored, and grown from more than any other. Getting to really know this other little person from day one, to love so completely and unconditionally another being that my own happiness and even safety ceased to be my focus, to revel in the miracles abundant in every stage of development, has gifted me with a blessedness and grace I could have gotten no other way. Now, I am FAR from a perfect mother, and my catastrophic nature kept me from rolling the baby dice more than once, but, most of the time, I feel pretty good about the job I'm doing. No doubt, my work as a therapist has afforded me a view of some of the most sorrowful and painful moments a human can experience. My kid's development, and my efforts in that direction, have been thankfully free from some of those more egregious scars. And I've always been a consciously grateful for any good mojo that comes my way. But now, as I anticipate my son's final year at home, I can't imagine my life without mothering as it's center. I am a softer, wiser, better person for having taken this path. Who knew a step I never considered taking could be my life's greatest joy?

It Is What It Is

Radical acceptance is the process of making the choice not to fight against "what is," but to lean into the reality of an experience with awareness and curiosity. This challenging task has its roots in Buddhist teachings, but the result of avoiding unnecessary suffering is a benefit everyone can enjoy.

Accepting Our Experience 

There is much in life we have little control over -- the traffic jam impeding our journey to work; our partner's surliness; our boss choosing a co-worker for a position we covet. But our lack of control rarely stops us from fuming, brooding, fretting or grieving over the reality in front of us. We think about how we could have garnered a different outcome, or rage over the unfairness of our "loss." We look for opportunities to sneak past the obstacles. We respond with similar frostiness to those who offend us. And while we may assume these reactions are instinctual and unavoidable, we truly have choices. And those choices offer us freedoms from negative, toxic or harmful emotions. If we instead embrace the time in a traffic jam to catch up on a phone call with an old friend, or pop in a favorite CD to enjoy some "car dancing," we'd likely feel much calmer when the cars ahead of us started moving again. If we choose not to assume our partner's bad mood is because of something we did or said, and instead allow them the respect to their own experiences without judgement or the attempt to change them, we may feel a freedom that comes with staying on "our own side of the street." If we refuse to give into bitterness or jealousy toward our colleague, and instead commit to supporting them in growing into their new role, we afford ourselves the luxury of directing our energy stores to those things at our job that can move us forward. Radical acceptance does not mean we don't hold others or ourselves accountable, nor does it curtail us from trying to change or improve situations when we can. Rather, by relaxing into radical acceptance, we allow ourselves the relief that comes from loosening our grip on what, in truth, was never in our control to begin with. 

Fear and Violence

When violence occurs, we may assume feelings like hatred, rage, or vengeance motivated the destructive acts. But more likely, fear is the impetus behind acting out. When humans feel threatened or at risk, our fear can propel us to lash out in an attempt to protect ourselves.

Fearing Fear Itself 

We may like to believe that we are "different" than people who behave violently. We are more civilized, intelligent, self-controlled. We are rational and logical. Perhaps. But we all feel fear. We fear being outcast; we fear conflict and expressions of anger; we fear falling short or disappointing others; we fear physical and emotional pain. These feelings are universal to humanity, and we can recall instances when we ached with the pain of each potential threat. While most of us don't react with physical violence when we are afraid, it isn't difficult to imagine how a deep, pervasive and constant sense of being unsafe could leave someone vulnerable to striking out. Violence is never the answer, but fear will always be with us. We have the responsibility to respond to our fears -- and others' -- in a way that heals and doesn't hurt. And that starts with acknowledging our fear. Far from being shameful or weak, feeling fear is a protective response leftover from our reptilian ancestors. Fear wakes us up to threat, calls us to be aware and ready to fight, fly or freeze to survive. Without fear, our species would not have lasted long on this planet. Respecting and appreciating what fear has to teach us, without hurting ourselves or others, can promote deeper understanding and empathy for what it means to be human. By accepting that we do and will experience fear, we provide ourselves with the opportunity to choose our path, rather than react with impulsive action. Violence is a learned behavior; the experience of fear is not. When we can understand what triggers fear in others, we can approach them with options that offer safety and freedom to choose from a place of empowerment. When we identify our own fear triggers, we increase our empathy for one of the most tender of human experiences. Embracing fear is a path to knowing, and holding, and protecting each other. 

Remembering Our Best

Perhaps it was the time we screamed at our kids, or belittled them in an effort to curb misbehavior. Maybe we snubbed a friend instead of pursuing a difficult conversation. Cheated on our taxes. Took something that wasn't ours. Manipulated a situation to get our way. We all have these kinds of regrettable moments in our pasts -- for some of us the list of transgressions seems woefully long. How can we look ahead with confidence and self-esteem when such poor choices and behavior lurk in our backgrounds?

Releasing the Worst 

Researcher and clinician Brene Brown writes, "We cannot be defined by our worst deeds." At first reading, my cognitive mind embraces that statement, 'Well, sure, everyone makes mistakes. We are all human and deserve forgiveness." But then my knee-jerk emotional self is quick to add "at least, everyone else does." So quickly and unconsciously, we hold ourselves to a different standard than we do others. In the face of someone else's moral failing or atrocious behavior, we may be willing to offer compassion for their flawed humanness, or at least to rationalize that they had some reason for their actions. But most of us are just as quick to not only judge ourselves more harshly for bad behavior, but also to roast ourselves over the mental spit of reliving these shameful moments over and over. As if grinding these cringe-worthy moments into our memory banks will somehow motivate us to better decisions in the future, shaming ourselves for our failures does the opposite of urge us to do and be better: it defeats and demoralizes us into believing our brokenness will forever keep us from being the "good" and "honorable" people we long to be. In therapy, I see proportionally more clients who berate themselves for long-ago misdeeds, rather than minimizing their wrongdoings. In general, I think most people internalize the voice of a faceless, harsh authority figure, one set on reminding us of every misstep we have ever made, even if it erases every shred of self-love we have managed to stockpile over the years. I've yet to see shaming effectively urge people to access their best selves. Similar to the way unconditional love helps young children to feel safe and confident stepping out into the larger world, our own positive self-regard is the path to behaving, choosing and speaking in ways that enhance our lives and others. We must let go of the negative loops of memories that condemn us for our failings. Instead, we can train ourselves to cast the spotlight on our moments of bravery, compassion, kindness and altruism. We can choose love -- even for our selves. 

Resolution Revolution: Living in the Unknown

Resolution provides answers, certainty, peace, even the opportunity to let go and move on. Resolving an argument can bring people together, allowing a deeper knowing of each other's viewpoints. Receiving test results from your doctor, even if the news is less than ideal, results in a choice of treatment plan and the power to be in control of one's path forward. But resolution is not always possible. How do we find peace when we are left with the "unknown"?

Moving from Black-and-White to Gray 

Young children operate largely in a black-and-white world. Rules of right and wrong govern their behavior, and they believe if something is "this," then it cannot be "that." We feel comforted when the world fits neatly into available "boxes" and we can predict the next steps based on what came before. However, most of us grow into more abstract thinking as we age, understanding that very little in life, in fact, is absolute. Grayness rules our world much more frequently than black and white. Finding stability and confidence amidst "what-ifs" is a perennial challenge. Some people take comfort in religious beliefs that offer meaning to life's difficulties. Others expend energy and resources in a search for answers that may result in deeper self-awareness, regardless of whether the answers appear. Ultimately, we must embrace the truth that much of life will remain a mystery, regardless of our energies to discover and define what we feel we "must" know to feel at ease. Rooting ourselves in the fertile ground of the unknown and unknowable can be the realist form of acceptance, setting us free from the  pressure of "doing" and allowing us instead to "be", a flexible and potent posture that will help us weather whatever lies ahead. 

"I (Don't) Want to Be Alone"

Alone time can be delightful -- an opportunity to replenish our psychological and spiritual stores, to putter and play mindlessly, to reconnect with our inner selves. But being alone is not the same experience as being isolated. Isolation is a destructive occurrence that crushes hope and fuels disconnection.

Alone in the Dark 

Researchers Jean Baker Miller and Irene Stiver have written, '"We believe that the most destructive and terrifying feeling...is psychological isolation...It is a feeling that one is locked out of the possibility of human connection and of being powerless to change the situation.'" (quoted from Brown, 2007). Some experts theorize that isolation is the largest psychological threat humans face. As a species, we need each other. We yearn to be known, to have our stories heard, and to feel valued. Isolation can take physical forms: we begin a new job and no one at our workplace has reached out to us yet. Or it can be an emotional affront: we risk being vulnerable with someone, and our feelings are dismissed or negated. Isolation can result in feelings of depression, physical illness, hopelessness and despair. As easily as we can "connect" with others thanks to technological advances, many people report feeling more cut off and lonely than ever before. Like most complex problems, isolation cannot be cured by simple means. But demonstrating empathy for others is a potent beginning to curbing this deep sense of aloneness. Listening to others with the goal of communicating an understanding of their experiences, of validating that you share what they feel or need, is a powerful tool of connection. Being "heard" communicates an acknowledgement of the other, a sharing of their truth. Connection is restorative. It builds hope and resilience. Listening and providing empathy are two gifts we can offer to affirm that, indeed, we are all in this together. 

Turn, Turn, Turn

Summer is a time of beginnings. Birds are re-building their nest in the maple tree out back. My son is planning activities with friends to make this the "best summer ever." We can venture to the farmers market again each weekend in our small downtown. My peony bush is bursting with magenta blooms. But endings accompany all beginnings. I've packed away my winter sweaters and drained the snowblower. The end of the school year means some friends will depart for colleges near and far. For children, structured schedules fall away to wide-open days of lazing in the yard, long bike rides and water balloon fights. The longer days and higher temperatures invite us all to consider ending or beginning a new chapter for ourselves.

To End is to Begin

What project or hobby have you been putting off? Do you want to decorate your porch with a container garden? Maybe try your hand at knitting, or woodworking? The joy you found in crayons and coloring books as a youngster might encourage you to sign up for a pastels class. Caring for yourself can create the perfect summer "to-do" list. Commit to walking each evening, even just around the block, to enjoy the extra hours of daylight and sumptuous summer smells of barbecues, blooming gardens, fresh cut grass. Enjoy healthy treats like cold slices of watermelon and tart Bing cherries. Take your dog to the park and replenish both your spirits with a vigorous roll in the grass. Or maybe you'd prefer to bid adieu to a bad habit. Banishing self-criticism or negative thinking are "endings" worth the effort. Putting an end to a toxic relationship could free you to the beginning of more fulfilling connections. Shedding old beliefs of limitation or lack provides us with an outlook of possibility.  Whatever your choice, embrace action with the fervor we enjoy these sunny days. Make a conscious choice to a beginning - or an ending -- that brings you freedom, joy and peace.

Dear Diary

Journaling is a common tool used to help clients make progress in therapy. Even if the idea of writing makes you cringe with memories of ninth grade English compositions, consider how chronicling your thoughts, feelings and memories can provide you with multiple benefits. 

Write It Out 

Journaling can be used to facilitate different kinds of growth, including:

1. Insight. Recording memories, our emotions, fears or desires, can provide us with a platform to look at patterns in our lives and understand what may be driving us to feel or behave in a certain way. Many people report re-reading their journals and discovering new areas to explore in therapy.

2. Catharsis. Pouring out our anger, resentment, or disappointments onto the page can create a feeling of lightness, allowing us to let go of old pain and move forward.

3. Documentation. For some clients, recording details of traumatic events is a way to bring validity to their experience. Trauma survivors can feel empowered by naming their experiences and recording their truth.

4. Goal-setting. Some clients benefit from creating a template for their goals. Writing down the steps they need to take increases their chances of success and provides accountability.

Journaling doesn't have to be a permanent record. Some clients discover a sense of transformation through burning their writing soon after they've finished. The act of burning or tearing up our written words can offer clients a sense of relief, or of moving beyond the material they transcribed. Remember, journaling isn't about following rules of grammar, spelling or composition. It's a process of discovery and development. The best part? All you need is a pencil and paper to get started. Go on -- write it down. 

The Family Triangle

When families encounter difficulties in communication, therapy can be helpful in providing skills and education to help members avoid further misunderstandings and negative dynamics. Sometimes, clients can benefit from learning to use "I-statements" to diffuse defensiveness, or reflective listening to ensure the correct message is being received from the sender. But other patterns of family interactions can create deep wounds and mistrust that can take intense work to remediate.

Three Sides, All Unequal 

Triangulation occurs when one family member avoids direct communication with another family member about his/her behavior, choosing instead to communicate with a third member about their concerns. For example, a mother may share her fear and frustration about her husband's alcoholism with her child, creating a peer-like relationship that requires more from the child than he reasonably can provide. In addition, the mother's sharing can create fear and anxiety in the child, or the child may feel responsible for "fixing" the situation. Triangulation causes a warp in communication, similar to the childhood game of "telephone," creating misinformation, distrust and confusion. Roles of parent, child and sibling can be upended, and emotional safety between family members suffers. Because triangulation can feel "rewarding" by providing some members with an inflated sense of power, or others with an "out" for confronting another, this dynamic often becomes entrenched. Counseling allows families to learn the real costs of these patterns, and how to approach one another with respect and honesty. We know that the shortest distance between two points is a straight line. Families learn that communicating directly with one another can bridge the distance between members, facilitating real intimacy and avoiding the woundedness and distress created by triangulation. 

Vanity, Thy Name is Narcissus

We've all known the type: the egotistical, self-centered lout who consistently trounces over the needs of others in his drive to be noticed and applauded. The abrasive scene-stealer who truly believes she is better than her peers, regardless of their characters or achievements. Or the insensitive, dismissive diva who can't put herself in another's shoes. Perhaps now more than ever, whether the results of entitlement or attachment issues first budding in infancy, narcissists seem to abound in our society.

"It's All About ME!"

Narcissism can run the gamut between a slightly overgrown sense of self (a character trait) to a pathological grouping of negative behaviors and attitudes that leaves pain and destruction in its path (a full-blown Narcissitic Personality Disorder). Now before you go "diagnosing" yourself as a narcissist because you stole your sister's dolly when you were 6, or because you chose to treat yourself to a massage rather than attend Aunt Velda's birthday party, remember that while everyone has moments of selfishness, rarely do we exhibit the consistent, extreme egotism and diminishment of others' realities that mark a true narcissistic person. Narcissists have a grandiose self-image, craving admiration and adulation from those around them. They have difficulty distinguishing themselves from outside objects, assuming that their feelings or perceptions hold true for everyone. Perhaps most troubling, narcissists lack empathy -- they cannot feel what others are feeling, blocking true intimacy, connection and a sense of being seen and known from the experience of the other. Individuals with personality disorders often are less aware than others of the destructiveness and toxicity of their behaviors. In fact, the continued negative feedback of others is the "push" that gets these folks into the therapy room. And while some clinical perspectives suggest personality disorders cannot be "cured", many professionals consider these clients to be some of the most damaged, traumatized people in society, and worthy of treatment to help them -- and those around them -- learn how to blunt the negative impact of their harmful behaviors and learn more appropriate ways to communicate, connect and manage intense emotion. The adage "hurt people hurt people" applies to narcissistic individuals. If you are in relationship with someone who exhibits narcissistic tendencies, consider pursuing counseling of your own. Learning how to set boundaries, attend to and care for your own feelings and needs, and resist taking on the other's emotional baggage as your own are vital skills for your own sense of self and internal balance. With intensive work and a skilled, committed therapist, clients with narcissistic personalities can learn how to share the stage of life, and leave room for others in the spotlight. 

"Good Enough" is Good Enough

Most of us know that the quest for perfection is futile. Try as we might, we know we will make mistakes. We will blunder and fail. We will fall short of a goal. But recognizing that we cannot be perfect doesn't mean that we feel "good enough."

From Good to Great? 

Clients often share their feelings of not being "good enough". They talk about wanting to be better, to do better, to learn and grow and improve.  But rarely do I cross paths with someone who has "gotten there" -- who has made it to the elusive state of "good enough." It's as if we believe that growth and enrichment aren't valuable in their own rights--we must go beyond that to feel satisfied. What would happen if we looked at ourselves in the moment and allowed that we are "good enough" just as we are, right now. We don't have to strive to do more or stretch farther. In this moment, who we are and what we do can be good enough. Rather than looking into the future to a time when we will be better parents, partners, workers or friends, we can accept that we already are. Somehow, we fool ourselves into believing that only through striving and effort can we earn our place at the table, and that, unless we are straining forward, we are not doing enough. We set ourselves up to believe that being acceptable is always out of our grasp. I suggest we break the mirror that reflects distorted visions of who we must be. Embrace who you are right now. Enjoy the freedom of release from the idea that anything about you could still be wanting. Regard yourself as you do those you cherish. Our loved ones don't have to "be more" to earn our adoration and respect. Nor do we. We are enough. We are good enough. Already. 

Aging Parents and Adult Children: The Challenge of Changing Roles

Human beings today are living longer than ever before. Some experts say that people will soon be living healthily well into their hundreds. But the needs of aging parents can be a source of stress, guilt and resentment for adult children in our hurried modern society. Counseling can be a space to help clients find the best path forward for their parents and their own families.

The Perils of Parenting Our Parents

Generations ago, multiple generations of family lived together, relying on each other to accomplish the daily tasks needed to keep the household running, and to increase the survival rates of all family members. Cultural norms dictated that adult children care for their elder members, and almost all families followed that same expectation. In the past, however, growing old and infirm was unlikely, due to rampant disease and poor health care. Now, most of us can expect to know our grandparents, even our great-grandparents, as the aging population increases. But unlike periods where communal living was the norm, and all family members were exposed to each other's bodies and functions on a regular basis, families today have different norms and expectations for boundaries and privacy. Older folks in their 70s and 80s regularly live independent lives, marked by autonomy and control of their decision making. Many adult children would feel awkward or disrespectful tending to their parents' physical needs, and many elderly would feel minimized or dismissed to have their choices dictated by their offspring. Today's family hierarchies typically clearly delineate the roles and rules surrounding the domains of parents and of their children, regardless of their age. Counseling can be a space where clients can examine their values, explore the options for their parents' care, and process the myriad feelings of grief, loss, fear, anger and resentment that often crowd the experience of a family as it ages. The therapy process helps each family come to terms with what works for them, and facilitates open and honest communication of all members's needs. Working together with a therapist skilled in family development over the lifespan, adult children and their parents can create a path forward that ensures parents age with dignity and respectful care, and adult children can feel confident they are honoring both themselves and the generation that paved their way. 

The Ties That Bind

The mythology of family reads like a fairytale: loving parents who don't yell or scold; strong sibling bonds that are forged from mutual respect and a desire to protect one another; communication that's fluid; boundaries that are flexible but still strong enough to shelter. The images of family our culture promotes highlight the ideals we all wish for and, indeed, deserve. But many families fall short of these picture-perfect scenarios, some, unfortunately, to dangerous degrees.

When to Sever the Ties 

Most therapists would agree that family relationships can be an integral part of our support network. Family members, we hope, champion us when we are low and celebrate us at our heights. Rarely do we recommend ex-communicating family members, advocating instead for clients to attempt to open communication, assert their needs respectfully and engage in conflict resolution to attain an equanimous end. But sometimes, clients find that an intimate relationship is destructive or toxic, no matter what efforts are made to change it. Whether due to the presence of violence, substance abuse or emotional manipulation, clients may decide that their very survival requires distancing themselves from people they still love. This decision is intensely personal and individual to each client; and almost always grueling to enact. It can, however, be an act of self-love and self-respect. The bonds that connect us should feel embracing and nurturing. When they become chains of fear or distress, or ligatures that constrict our growth, we may have to choose ourselves over the dreams of a family that is not to be. 

The Child Inside

The concept of the "inner child" has been a near-constant focus of therapy since the 1970s . From psychiatrist Charles Whitfield to new age practitioner Louis Hay, helping professionals have advocated clients accessing their "inner child" to understand unresolved childhood wounds and to facilitate healing, growth and insight.

Learning to "Self-Parent"

We all have unmet needs, long-held disappointments, grief that's been stuffed down or unexpressed. Rarely are the "fits" between parent and child so perfectly matched as to avoid hurts, assumptions or misunderstandings, especially during the early years of life. We may long for the unconditional love we were unable to feel from our caretakers, or for the praise or recognition that may have been inconsistent. The beauty of acknowledging and understanding the needs and hurts of our youngest "parts" is that we no longer need to rely on others to provide us what we lack. With the guidance of a skilled therapist or spiritual counselor, we can learn how to identify and validate the pain we still carry from decades-ago events. We can develop the skills to tend to our hurts, to respond to our needs with compassion and nurturance. We can rewrite the negative scripts programmed unconsciously in our childhoods to include a more balanced, affirming and forgiving sense of self. We are no longer reliant on others to assure us of our value. We can be our own "inner child's" good-enough parent, encouraging, loving and cheering ourselves on to a more healed and resilient self. 

Overeaters Anonymous--Providing Nourishment for Recovery

Addiction and the desire for recovery are common reasons people seek out counseling and twelve-step groups like Alcoholics Anonymous and Narcotics Anonymous. Due to public education, more laypeople and professionals are gaining understanding about the similarities between alcohol and drug abuse and process addictions like sex, gambling and workaholism. Some substances can be avoided completely--like alcohol or drugs--but one addiction involves a necessity to our existence that we cannot live without--FOOD.

Finding a Food Balance 

One accessible and effective tool for people with an unhealthy relationship with food is Overeaters Anonymous (OA). Despite its name, the twelve-step program of OA is applicable to individuals with a variety of eating difficulties, from anorexia and bulimia, to binge-eating and overeating. Similar to AA and NA, OA utilizes support group meetings, peer sponsorship and OA-approved and -produced literature to help participants learn how to manage their addiction behaviors around food, and to provide an understanding and empathic environment for people to begin their individual recovery plans. While some twelve-step programs approach abstinence with an universal agreement of its definition, OA is unique in its approach of supporting each individual in customizing her commitment to abstinence based on one's type of eating disorder, medical diagnosis or personal dietary needs. If you think you may have a disordered or disruptive relationship with food, or are concerned with how much food occupies your mind and daily tasks of living, consider consulting with a clinician who specializes in eating-related treatment, or seek out an OA meeting in your area. Food is a requirement for life, but it need not be a source of pain, anxiety or anguish. 

The Reward of Authenticity

One of the scariest risks we take is the choice to be authentic. Being real with others requires us to be vulnerable -- if we are rejected or misunderstood, we can't blame others' reactions on the mask we are wearing. We feel the pain more deeply when our truth is maligned, our dreams dismissed. But intimacy is only possible when we offer up our authentic selves.

The Real Deal

Sharing our real feelings, our fears and fantasies, our secrets and failures, requires courage and resilience. When we let someone in to see our authentic self, we are demonstrating deep respect for the other. We are saying "You are important enough for me to risk showing you the 'real me.'" Being authentic is a priceless gift, and the only way we can truly feel accepted is when we know it's really us that our partner is embracing. If we present anything less than our genuine selves, we can never be sure that the affection or respect we receive is ours to keep. We question the strength of a connection that could be based on who we WANT to be, rather than who we truly are. Security comes from a sense of safety, and safety is elusive without the foundation of Realness. 

The Web of Life

The hiking paths in Red Rock Canyon provide breathtaking views of red mountain ranges, limestone formations that have existed since the time of dinosaurs, and occasional sightings of wildlife--from thumb-sized geckos to stubby burros and majestic wild horses. The landscape is dotted with cactus, mesquite, patches of wild, deep green grasses. Making our way across the rocky trails was a reminder of how we -- like nature -- rely on our environment for sustenance and support. When drought hits, animals can count on the lifesaving liquid inside the cacti to tide them over until the rains come. Shallow, dry river beds are dotted with stones and boulders that artfully contain rainfall and direct it to parched areas that need it most. Like the interconnectedness of desert animal to its landscape, we humans are as much a part of each other's survival. The mountain caves offer cool respite on scorching summer days, as we can provide a safe embrace for those who are overcome by life stressors. As the sun-heated rocks support nimble lizards with a natural "warming station," our words of comfort and encouragement can help others access their courage to take risks to move toward better circumstances. Like the river beds protect the water supply, we can guard each other's dreams and provide emotional sustenance. We are part of a system that grows and thrives optimally when we allow  our individual gifts to be "used" by one another to move us all forward.

The Expert Within

Our family has slated tours of several colleges onto our spring calendar, and my son is logging hours in an after-school class to prepare for the ACT test. We are about to embark on a journey dotted with questions, marked by difficult choices. Other parents, teachers, and college advisors are stressing the importance of choosing the "right" school, suggesting that the college my son attends could mean the difference between almost-certain career success, and having to claw his way into his field from a one-down position. When I was college-shopping myself 25 years ago, my most important criteria were location, affordability and frankly, whoever would accept me. Now, the competition for admission appears fierce, and the pressure to choose "wisely" is so intense, that we almost lost sight of the one constant that trumps all others-- trusting ourselves.

The Truth Is IN There

Our family has weighed the opinions and wisdom of the experts, and we have invested our energy in educating ourselves about our son's college options. But, as in any decision, I've reminded my son that HE knows himself better than anyone else. HE knows his passions, his priorities, his needs and wants. What might be the "optimal" college for networking with top players in his dream field may not offer him the social justice opportunities or the spiritual sustenance that he values as highly. The "renowned" faculty may not be able to provide him with the personal, mentoring relationships that help him most to thrive. While my son has talent and ambition for his art, he also prioritizes giving back to his community. I've reminded myself, and my son, that HIS "right" choice will reveal itself if he just pays attention and listens--not to the "experts", but to the truth within himself. 

The Practice of Gratitude

Cognitive behavioral interventions are some of the most common, and most effective, tools we use to teach clients to manage their depressive symptoms. Addressing mistaken beliefs, meditation and deep breathing exercises, and replacing negative scripts help clients to feel more hopeful, gain perspective and  a sense of control and competency. But one of the most powerful practices I've ever recommended is also deceptively simple: a gratitude journal.

Counting Your Blessings 

My first introduction to the concept of a gratitude list was in Sarah Ban Breathnach's book, Simple Abundance. She suggests recording three to five events or moments each day to "retrain" ourselves to see the grace and beauty in everyday life. News of tragedies, natural disasters, crimes and catastrophic illness flood our awareness through television, newspapers, social media outlets. We can easily become accustomed to expecting the worst, or even numbing to the pain we see around us. But taking a few moments at the end of each day to record positive moments can help lift the veil of pessimism. I suggest clients notice their  "unremarkable" good fortune--finding the closest parking spot during a rainstorm, the gurgling baby ahead in the grocery line, the smell of fresh laundry, the feel of a new pair of socks. By focusing on the spots of sunlight in the everyday, we realize that gratitude is a daily choice, that our blessings surround us in boundless ways. We would all be overjoyed to win the lottery or survive a car accident. But the smallest moments are constant opportunities to notice, to appreciate, to be reminded of just how lucky we really are. 

All the (Therapy) World's a Stage

"Why does therapy have to be HARD?" I empathize deeply when clients ask this question.  Indeed, therapy can be difficult, scary, exhausting and confusing. Clients exhibit great courage when they are willing to dig deep, to be vulnerable, to feel and examine feelings and experiences that they may much rather hide or avoid. I am not a believer in the "unavoidable necessity" of reliving trauma, or in advocating that the only path to healing is to brave through, yet again, life moments that tore us asunder the first time around. But I do know that therapy asks of us to be honest with ourselves, to face our truths (even if they are messy or ugly or unpalatable to others) and through that examination, to develop an understanding of and compassion for ourselves that helps bring value, purpose and even peace to our lives.

Comedy, Romance, and Thrillers 

The therapy hour may not always be a somber place. My office has been the stage for some of the most hilarious stories I have ever heard. I have laughed with clients until tears ran down my face, and we were left wheezing for breath. I've hooted and hollered in celebration of clients' successes, and beamed with joy when I've been lucky enough to meet a client's newborn baby, or to gush over an engagement ring. Therapy is never simple, but the "hardness" of therapy doesn't automatically mean deep pain or reliving old agonies. If the timing is right, the fit  between client and therapist is flexible and connected, productive therapy through difficult terrain more closely resembles the soreness of a good workout. We may feel spent, tender, a little out of breath and perhaps surprised by our efforts. But we also feel accomplished, courageous and proud that we faced, discovered or spoke our truths without turning away. Human beings are resilient creatures. And therapy can be a forum to safely and cooperatively do the "hard" work of mining our psyches and our souls, and unearthing power and potential we never dreamed we contained. A worthy payoff, indeed.

A Dog's Life

We left the vet's office in a fog of disbelief. Hearing words like "carcinoma," and "chemotherapy" and "palliative care" is surreal for anyone faced with a loved one's diagnosis of cancer. But looking into the eyes of the 10-pound bundle of fur I carried in my arms, knowing those words meant nothing to her, that we couldn't explain or reassure her about the challenges she faced, I experienced a helplessness I had never known.

A Road Less Travelled 

Desi has been a part of our family for more than 10 years. From her start as a palm-sized puff of silky hair and round protruding eyes, through three litters of puppies, and countless hours of couch-cuddling, neighborhood walks, and watching her chase the cats through the house, she has been a constant source of love and laughter. My wife and I felt powerless to help her, and frustrated by our inability to prepare her for what lay ahead. Illness is a challenge to the strongest and surest of us, a path dotted with questions, what-ifs, unknown outcomes. We have the chance now to be the strength she needs, to support and calm her when she's scared or exhausted. We have the privilege of walking with her down what may be the final trail of her life, to be witness to a life that matters not because of exalted achievements or extravagant earnings, but simply due to the love her presence has supported in our family. None of us, I'm sure, would have chosen this road. But navigating it together, taking this risk that is love even though the cost may be great loss, is our effort to mirror her unconditional acceptance. We are here with you, Desi, wherever these next steps may lead, whatever the end may look like. You are our blessing. 

Just Do It

Always Do Your Best. Upon first reading, the fourth agreement in Don Miguel Ruiz's book, The Four Agreements, seems nearly impossible to uphold. I assumed (yes, I'm aware that I managed to break one of the agreements before I even finished the list) that my "best" referred to some mythical extreme effort, some standard of exalted achievement that I could only hope to reach if the stars aligned. But Ruiz offers a more reasonable definition: do what is your very best at any given time. When I am feeling confident, skilled, or even rested, my best looks very different than when I am anxious, confused or exhausted. What I am able to accomplish or strive for is influenced by both my strengths and my weaknesses, and I can never be falling short if I accept my efforts with compassion and integrity. Doing our best doesn't have to mean that we knock it out of the park. All we must commit to is swinging as hard as we can.

Avoid the Guesswork

"Don't make assumptions" is the third guideline for living with integrity, according to Don Miguel Ruiz' book, The Four Agreements. The assumptions he writes about include predicting the outcome of situations, "mind reading" others, or even limiting our risk-taking because we doubt our abilities. Ruiz maintains that asking questions is the surest way to avoid the assumption pitfall. With accurate feedback, we can learn our partner's true needs, rather than guessing at what they want. We can accumulate facts rather than rely on hunches. By asking questions, we can assess the reality of risk, rather than catastrophizing ourselves into a paralysis of action. Asking questions demonstrates curiosity, a willingness to own what we don't know, and allows both parties to be a part of co-creating movement forward. When we don't assume we have all the answers, we allow room for authenticity and truth to flourish.