Friday, April 26, 2013

ABCD and Dirty Coffee Filters

ABCD and Dirty Coffee Filters 
Amy Grabowski, MA, LCPC

"Someone at work made a comment and before I knew it I was convinced that everyone at the office hated me. I felt so bad that I cried all night." "I don't know what happened. I was feeling OK and then all of a sudden I felt depressed and worthless. I ended up eating all evening."
Sound familiar? My clients tell stories like this all the time. I usually ask them to examine the event and look at what thoughts flashed through their head immediately before the feeling. Even if we are not consciously aware of it, the way that we think about things that happen to us effect the way we feel about ourselves. Often these thoughts are full of distortions and old messages. I recommend a book FEELING GOOD by David Burns which helps to recognize and change our distorted thinking. But I think we have to look even deeper and change the core-beliefs we have about ourselves. I often tell a story that actually happened to me many years ago: I was waiting for an elevator. When the elevator doors opened, a male co-worker stepped out, looked at me, gasped, made a weird face at me and hurried off without saying hello. If this happened to you, how would you react? Most people say they would think, "I must have done something wrong to make him mad at me." "He must think I'm fat." or "He doesn't like me." Consequently they would feel self-doubt, bad about themselves, self-conscious and very self-critical. This would effect what they do the rest of the day. These negative feelings about themselves would make them withdraw or isolate themselves, and lead to binge eating or self-loathing.
After I tell my story, (I'll tell you how it really turned out later), I write ABCD on a piece of paper. A stands for Action: what happened, the actual events: in this case, the man making a face and hurrying off. (These events may or may not be under our control.) C is for Consequence: what we think about what happens and how we feel: "He's mad" and feeling bad. D is for what we Do: how the consequences shape our future behavior: isolating and withdrawal.
I purposely skipped B because our brains process things so fast, we go from Action to Consequence so quickly that we usually are not aware of B. B is our Belief System, what we say about ourselves deep in our core, what our identity is based upon. Many times if we go inside, we will find a small voice that truly believes "There's something inherently wrong with me." "I'm really not good enough." or "I am not likeable or lovable." Most clients would never say things like this about another person, yet regularly think this way about themselves.
Why do we think these things about ourselves? Our belief system is like a coffee filter. When things happen, events trickle through our belief system and the consequence is what comes out, effecting what we do. Our belief system (coffee filter) is full of old messages we received about ourselves when we were children. These messages come from many sources: our culture, society, religion, family, friends, teachers, relatives, etc. These messages may have been very subtle, i.e. a teacher who only chooses boys for the answers in math may be giving a young girl the message that "Girls can't succeed in math." Or only seeing skinny women on TV gives the message that "Women must be skinny to be loved. I'll never get married if I gain weight." If a parent was always angry or depressed, some children "hear" messages that say "You aren't good enough to make me happy." For some, the messages received from their dysfunctional families were very direct: "You'll never amount to anything." Repeated over and over again, children internalize these messages without question to form their belief system.
When we have a lot of negative self-beliefs it is like a very dirty coffee filter. If you never changed your coffee filter, the coffee would taste awful. Since we haven't changed our belief system in a long long time, the thoughts and feelings we have about ourselves make us feel awful. In order to feel better about ourselves we need to "clean our coffee filter": change our core belief to healthy self-enhancing ones.
In order to this, we usually need to work with a therapist who is trained in this process. If we try to do this alone, our critical parts may take over and agree with the part that is saying "I'm worthless", thus reinforcing and perpetuating these negative self-beliefs. Often we need someone who can help us mediate between the critic and the "worthless" part so that the two don't become even more extreme in their negative beliefs. We need to turn the critic into an ally, like a friendly coach or manager who will work with us instead of against us. We can ask the coach/manager to positively motivate us so we can accomplish what we really want out of life. Then, with empathy and nurturance we can help the "worthless" part to let go of the burden of worthlessness. (Babies are NOT born hating themselves! And neither were you.) Without the burden of worthlessness, this part can become what it was meant to be: free, playful, allowing us to have fun and see life as enjoyable again.

Monday, April 15, 2013

Breaking Anxiety's Grip

Breaking Anxiety's GripAmy Grabowski, MA, LCPC

"My heart beats so fast that it feels like it will explode out of my chest..." "A feeling of doom washes over me. Everything looks bleak and scary...." "My thoughts start to race... What if? What if? What if?"
When I was 19, I started to feel anxious and have panic attacks. Looking for help, I described how I was feeling to a doctor. He blankly diagnosed panic attacks, handed me a prescription for a tranquilizer and walked out. I felt alone, like some kind of shameful freak.
What I really needed from him, I didn't get: an explanation, and some reassurance that I was going to be OK.
When clients come to me with anxiety, I help them heal themselves in four ways. First, I give them reassurance that they are definitely NOT alone with these feelings. Anxiety is the #1 reason Americans seek counseling. Secondly, I help them understand anxiety, how it develops, and how to feel more "in control" of it.
Third, I teach them ways to help them stop the anxiety spiral. Then fourth, they learn how to comfort the "part" of themselves that becomes anxious. Anxiety is excessive worry that is difficult to control. It causes: restlessness, being keyed up, feeling on edge, fatigue, difficulty concentrating, irritability, muscle tension, difficulty falling or staying asleep, or restless unsatisfying sleep. (If you think about it, most people in our high pressure society feel anxious.)
Panic attacks are periods of intense fear or discomfort, with physical symptoms that develop abruptly and reach a peak within 10 minutes. These symptoms include: pounding heart, sweating, trembling, shortness of breath, feeling of choking, nausea, abdominal distress, dizziness, faintness, feelings of unreality or being detached from oneself, fear of losing control, fear of going crazy, fear of dying, numbness, tingling, chills or hot flushes.
When you understand anxiety, it becomes less frightening and then can be dealt with in a calmer more logical manner. Anxiety is an instinctual survival mechanism - developed millions of years ago. When Ms Cavewoman saw a sabertooth tiger, her brain registered a "threat", and activated her "fight or flight response". Her body gives her a squirt of adrenaline to make her heart beat faster, lungs breathe more rapidly, thoughts come more quickly, and her muscles to tense up - so that she could fight or flee. This is all well and fine if I am about to be hit by a Northbound Lincoln Avenue bus. That automatic squirt of adrenaline burns off as I run for my life.
But, most "threats" in today's society are abstract. Our brain cannot tell the difference between a real threat and an "imagined" threat. So when we think "Oh no! What if I gain weight?" or "Oh my God! My boss won't like me if I speak up!" we get the same automatic squirt of adrenaline - even though you would never start a fistfight or flee in terror.
Worse yet, we notice our bodies' symptoms and think "Oh no! I'm shaking! What if someone notices?" Our mind sees this as another threat, and before you know it, squirt! - another dose of adrenaline. This speeds up our bodies and minds even faster. When this is noticed, "Oh my God! What's wrong with me?" - (you guessed it) squirt, more adrenaline. And so on, and so on. To stop this out of control cycle, we need to recognize anxiety in our bodies. I often ask clients, "Where in your body do you feel anxiety? What does it feel like?" If your first anxiety symptom is a "lurch" in your stomach, then the next time it occurs you may recognize it and process it in a way that avoids the out-of-control-spiral.
Deep breathing exercises, visualizations, and other techniques can halt the anxiety spiral. For example, visualize the most calming color imaginable, and then the color of your anxiety. Take a deep breath in through your nose, and imagine that you "breathe in" your calm color. When you breathe out through your mouth, "exhale" anxiety. As you breathe in your calm color, imagine yourself in a calm setting, such as a beach, a cabin or anywhere that feels safe. As you exhale your anxiety, imagine that it floats away from you like smoke or confetti in the wind.
Since anxiety tends to make us zoom into the future, especially with "What if" thoughts, introducing a "mantra", a calming phrase that is repeated over and over, can be very reassuring. A mantra such as "Right now, this moment, I am not in danger" can bring us back to the present.
Sometimes just identifying that we are feeling anxiety and are having body symptoms, (but without the catastrophizing), can be calming. For example, "OK, I'm having body symptoms. So what? Nothing's going to happen" After doing all this for a while, you will feel in control of the anxiety by breaking the upward spiral of symptoms that had you in anxiety's grip. But it is not enough to just control the physical symptoms of anxiety. To finally stop the anxiety from reoccurring, you must address the underlying issues that started the anxiety originally, - usually with the help of a licensed counselor.
For each person, these underlying issues are unique. Yours may be based on family dynamics from years ago, or a trauma that never fully healed. Whatever the cause, the process of resolving these issues is the same. Feel a bit of the anxiety. Then visualize this feeling as a "part" of you who needs something from you. Often this part will be a younger version of you that is stuck in the past, and can't move forward because it did not get what it needed then.
If you imagine sitting next to this part, you may feel empathy and compassion for the part. Ask the part what it needs from you, what words it wants to hear more than anything else. Often the parts wants validation, acceptance, and reassurance -- phrases like: "Its OK to feel this way." "You are still good enough even though you're scared." "It's going to be all right." and "You are not alone." Write these phrases down on a card and pull out your card whenever you need to calm down.
When the part is calmed down, then you, your adult self, can take care of what caused you to become anxious in the first place. It sounds easy, but it does require work and persistence on your part. Using the guidance of a licensed counselor, you can finally resolve these underlying issues. Breaking the grip of anxiety will spiral you upwards -- to happiness, health and success!

Thursday, April 11, 2013

Anger, The Misunderstood Emotion

Anger, The Misunderstood Emotion
Amy Grabowski, MA, LCPC

A long time ago, I read an article called "Anger Is Your Friend." I thought the author was daft. How could an emotion as scary and taboo as anger be your friend?! I don't remember the actual article, but it started me thinking about anger. And my fascination with the subject spurred my own healing of this misunderstood emotion. Of all the emotions, anger is the one that many people fear and avoid the most.
What is anger? Anger is just one emotion in the full spectrum of emotions, just as blue is one color in the full spectrum of colors. And just as there are many shades of blue, there are many shades of anger, from mildly irritated to violently rageful.
Anger is usually a defense reaction to situations in which our "self" feels threatened. It is a natural, healthy emotion; we are born with it. When we were babies, if someone took our rattle, we got angry. We would scream in order to get our rattle back. When our rattle was returned to us, we learned that anger is useful and productive.
When expressed in appropriate ways, anger can be very constructive. By listening to our anger we can learn about ourselves. Anger tells us how we want to be treated and when we feel mistreated. It tells us about our boundaries and our limits. It can help us enhance our sense of self, and help us to know ourselves better. Resolving anger can help us to change negative patterns and to feel in charge of our lives.
Here's an example of a situation in which anger is expressed in a healthy way. Something happens that makes someone angry. The ones involved (and only those involved) express their anger in a way that says "I am angry at something you did. Here's what I want to happen. What do you need in order to help me make this happen?" The issue is then discussed until a mutual feeling of compromise has been reached. Both parties in the issue come out ahead; its a win-win situation. Through this interaction, anger is seen as something positive that helps resolve problems.
But anger can be uncomfortable and scary. First, society discourages us from expressing anger. If we get angry, we are thought of as crazy or out of control. Women are especially discouraged from expressing anger. When women get angry they are labeled as a "bitch" or "hormonal" and weak.
Secondly, many of us fear anger because of family patterns that taught us that anger is frightening, destructive or even dangerous.
In the first case, families avoid anger like the plague. Any hint of anger may have been met with "Don't you raise your voice to me, young lady!" or some other message that said that anger was not OK. In response we learned to rationalize our anger away. "They didn't really mean it......I shouldn't feel angry." In our attempt to talk ourselves out of being angry, we created a conflict inside ourselves. "I shouldn't feel angry, but I do feel angry. Therefore there must be something wrong with me." We spend a lot of time and energy avoiding anger. We ask ourselves "Do I have a right to be angry?" This would be like asking yourself "Do I have a right to see the color blue?"
When we suppress or rationalize our anger, we fail to learn an important lesson: anger can change and to resolve problems which gives us a feeling of personal power and control in our lives.
In the second case, all anger is expressed in an explosive and destructive way. In some families, any minor offense was met with name calling, shaming, screaming and yelling, or worse, hitting and physical abuse. While anger was expressed more freely than in the anger-phobic family not only was it much more destructive and scary, the family members also never learn how to resolve conflicts.
The first step to healthy expression of anger is to learn to stop avoiding it. When we stuff our anger it builds up. Pent-up anger is hard to control and we often will blow up inappropriately. Pent-up anger also builds up until it turns into rage. It is safer if we vent our anger when it is petty irritations. When we take care of our anger as soon as we realize we feel it, it will not build up.
Sometimes in a relationship, we find ourselves repeating unhealthy patterns. It is easy for us to see what how others make us mad. But it is hard for us to see what we are doing that keeps the pattern going. In her book The Dance of Anger Harriet Lerner describes relationships as circular dances. Each person's dance steps perpetuates and reinforce the other person's dance steps. We do not have control over other people, we cannot change other people, but we can change our own behavior.
If we were dancing the polka with another person, we would both be contributing to the dance. We would only be able to continue to dance as long as both dancers danced. If one of us were to change to a tango, the dancing would change, the polka stops.
Similarly, in a relationship, patterns can go on only as long as both parties continue it. If either person changes anything about the pattern, something would change. It is very empowering, especially for women, to see that they actually can make positive changes occur in their lives just by changing their own behavior.
Many people find that taking a class in Assertiveness Training very helpful to learn what to say to facilitate these positive changes.
But if your fear of anger is paralyzing, short term individual therapy focusing on this problem can quickly get to the root of your anger-phobia. Then you can be "friends" with your anger.
Amy Grabowski, MA, LCPC is the Director and Founder of The Awakening Center. She works with clients individually and in groups to establish balance, cooperation and harmony among their "parts"; and a feeling of calmness, compassion and inner strength from their core "self". She specializes in women's issues especially: eating disorders and body image problems; anger, depression, anxiety, low self-esteem; couples communication and parenting skills; spiritual and personal growth. Sliding fee/Insurance Available. 

Sunday, April 7, 2013

Control...What Is It?

Control...What Is It?
Amy Grabowski, MA, LCPC

"I am out of control!" "He was trying to control me!" "I have no control!" "I lost control!" "I want to feel in control of my life?"
In my 9 years of practice, the one word that I hear the most is "Control". What is it? Why do so many people want it? How do you get it and use it?
During my first session with new clients, I help them to set goals for the course of therapy. Inevitably they say they want to feel "in control". But when I ask them to define control, they find it is very difficult to define. They will usually say what it is by describing how they do NOT want to feel when they don't have it, "I don't want to feel crazed, like the world is running past me and I can't catch up." or "I don't want to feel like I have no choice, like I just have to do what the other person expects of me."
The Webster's dictionary has many definitions for control: "the power to regulate or guide; to hold back, restrain; to exercise authority over; direct; command". But the control that these clients describe is more elusive than that. It is a feeling of having the ability to regulate and guide your own actions. It is a feeling of confidence and competence that you can handle whatever happens in day to day life. It is also a deep core feeling of strength that you can tap into so that you will feel your life is your own.
I want to make an illustration to help you understand control in a way that makes it attainable. Think of this whole newsletter as the whole World. The big circle is your world. And the small dark circle inside the large circle is all that you can control in the whole world. When you control what is yours to control (the small dark circle) and do not attempt to control what is not yours to control (the big circle or more), then you feel "in control". But when you try to control what is outside the dark circle, you are trying to control what is not yours to control, you feel as if you have "no control". If you do not control what is yours to control in the dark circle, you will feel "out of control". And moreover if you allow someone else to take over and control what is yours to control then you feel "controlled" by them. The combination of all of these different ways of not being "in control" makes people feel intense feelings such as anger, resentment, or anxiety which they then call "losing control".
"Jill" had a habit of never putting gas in her car (not controlling something that was hers to control). Several times on her way to our therapy sessions, Jill called me saying she had run out of gas, feeling very anxious (out of control). Jill's mother used to constantly remind Jill to put gas in her car (letting someone else control something that is yours to control), and Jill would complain to me that her mother was always telling her what to do. "She's trying to control me and my life." I pointed out to Jill how her own behavior reinforced and perpetuated the problem with her mother. Jill realized that by taking back control of the situation, by making sure that her gas tank was always full, her mother was able to back down and Jill again felt in control of her own life.
Another problem is when some people seek control the same as they seek perfection. They think that if they are always in control, then they will never say or do the wrong thing, they will never make a mistake and then bad things will never happen to them. Because they have a hard time not being in control of everything, they tend to overwhelm themselves (lose control) by trying to do too many things, perfectly. It is hard for them to allow others to do things for them, because they often feel that "If you want something done right, then you have to do it yourself." They, also, want to control everything that other people think, say and do, and the thought that other people may have negative feelings or thoughts about them is unbearable.
"Kelly" often found herself feeling out of control. She felt her husband was controlling her. Her husband was an outspoken man and often suggested that Kelly do things a certain way. She would do these things even when she didn't feel like it or want to because she said "He made me do it". She also felt that she could not do things she wanted to because, "He won't let me." My reply was that unless someone has a weapon, they cannot "make you" do anything. We discussed what was controlling her, and she realized that she was afraid to disagree with her husband because he might get angry at her. When we pursued this further, she did not think that he would ever hurt her in any way, but just the thought that he might get angry and be displeased made her feel very anxious. So, her own fear of his reaction to her behavior was what was really controlling her. We worked with the "part" of her who feared anger, so that she could decide for herself whether she wanted to do something or not. If she did want to do something, she did it because she wanted to, not because she felt she had to, or that he was making her. And also, if she did not want to do something, she was able to tell him why and deal directly with his reaction. Surprisingly, most of the time when she said no, he did not react in anger and they were able to discuss what they wanted to do instead. When he did get angry, Kelly was able to soothe that young part within which got scared, so that they were able to discuss it without Kelly feeling like she had to give in. The result was that Kelly felt much less overwhelmed and much more in control of her own life.
When I give the circle example to people, I often get two responses. One is relief. "You mean I don't have to control everything! I just have to control what is mine?" The other reaction is disappointment. "No! If I don't control everything then I will be unimportant! I'll be nothing!" But it is by feeling in control of your own life that you recapture a true feeling of inner power, which is very far from being a nothing.
In my office I have a sampler upon which is stitched The Serenity Prayer, with one small 'revision'. It reads:
God, Grant me the Serenity
To Accept the Things
I Cannot Control,
Courage to Control
The Things I can,
And Wisdom to
Know The Difference.
I wish you Serenity, Courage and Wisdom.
Amy Grabowski, MA, LCPC is the Director and Founder of The Awakening Center. She works with clients individually and in groups to establish balance, cooperation and harmony among their "parts"; and a feeling of calmness, compassion and inner strength from their core "self". She specializes in women's issues especially: eating disorders and body image problems; depression, anxiety, low self-esteem; couples commun-ication and parenting skills; spiritual and personal growth. Sliding fee/Insurance Available.