Feelings as Facts

A patient recently told me she felt unloved.  She blamed her husband for not doing enough to demonstrate his love for her and said she was having doubts about whether or not to stay in the marriage.  I asked her how long she'd been feeling this way.  "Not long," she told me.  "Maybe a week."  I asked her what had changed about her husband's behavior over the past week.  She was not able to identify a single thing her husband was doing differently than he'd been doing when she did feel loved.

The problem, I concluded, was that she was accepting her feelings as fact.  This is called emotional reasoning and it goes something like this: "I feel unloved; therefore, I must not be getting enough love from my husband."  Another example: "I feel anxious and worried; therefore, something must be wrong."  Yet another example: "I feel sad/depressed; therefore, something must be wrong with or missing in my life."

Now any of these statements might be true.  However, feeling a particular way is not enough evidence for us to draw any conclusions one way or another.  We need more information.

The point is this:  Feelings are not facts.  Emotions are a valuable source of information but they should never be the only source of information.  This is particularly true with those emotions that have been problematic for us in the past.

Here's a personal example.  I used to be very insecure and jealous in romantic relationships.  I became upset when my significant other talked to or even talked about other females.  It didn't take long before this caused problems for me.  I often over-reacted to benign situations.  My suspicions and accusations pushed those I cared about away.  I knew I had to make some changes.

I started to interpret feelings of jealousy as a sign (or a "red flag" of sorts) that I need to take a step back or remove myself from a situation for a few moments.  First, I would acknowledge my feelings of insecurity.  Then I would attempt to determine whether or not they had any basis in reality.  Sometimes that meant calling a trusted friend or family member to explain the situation and get their point of view.  If I determined that I was over-reacting (because of my own insecurities) I did what I needed to do to cope with my emotions without taking my feelings out on my significant other.  If I decided that my significant other had, in fact, done something to warrant my jealousy I worked to identify an appropriate way to address the issue with him.

This took a lot of practice but over time it became second nature.  Eventually I even started to feel more secure in my relationships.

Anyway, the moral of the story is that accepting feelings as facts can create a lot of problems.  To really make good decisions you need a good balance of reason and emotion.  In other words, when your head and your heart are in agreement you know you are on the right path.

Practicing What You Preach

I'm the kind of person who sort of jumps from interest to interest.  For a while I'll devote a lot of time and energy to something.  Then my interest sort of fades and I move on to something else.  It's the same way in my professional life.  I like to learn new modes of therapy.  For a while I become very interested in it.  I read everything I can get my hands on and I incorporate it into my sessions with as many patients as possible.  After a time, something else catches my interest and I move on. 

I don't think there is anything particularly wrong with that way of doing things per se.  However, I believe I would probably better serve my patients by maintaining my enthusiasm for learning new treatments while not completely abandoning the "old" ones. 

I started thinking about this the other day.  I had a patient who could really benefit from mindfulness training.  If you can teach someone to practice mindfulness you can help them learn to better tolerate their emotions, which leads to increased emotional stability.  I dusted off the file labeled "Mindfulness" and pulled out my outline.  (Yes, I'm a dork.  I create outlines so I make sure to cover all the important points).  I hate to admit that I've sort of slacked off in my daily mindfulness practice.  As a result I'd sort of forgotten why I'd been so enthusiastic about it before.  I explained the mindfulness skills to my patient but I was nowhere near as confident as I used to be.  Fortunately, the patient didn't seem to mind.  She was genuinely interested and expressed a willingness to practice mindfulness regularly. 

Explaining mindfulness to my patient reminded me of how much peace it has brought me in my own life.  I need to go back to it, if for no other reason than to be able to confidently share it with those patients who could surely benefit from it.  In other words, if I'm going to "preach" it then I need to practice it.

Toxic Relationships

I've often wondered why some are so reluctant to end their relationships with toxic people.  I've had friends who continued to let people back in their lives over and over again even after these people repeatedly turned their backs on them.  When it inevitably happened again they were genuinely surprised and hurt.  I never understood their surprise, as whatever the person had done this time around was completely consistent with his or her past behavior.

Now don't get me wrong.  I believe in giving second chances.  Everyone makes mistakes and in general people deserve to be forgiven.  For me the problem is when the same person repeatedly engages in behaviors that are hurtful to me in some way.  At what point do you say enough is enough?  At what point do you decide that you don't want this person in your life anymore?

Relationships and/or friendships with some people are simply toxic.  The longer you maintain the relationship the more toxicity you allow into your life.  Here are some of the qualities of a toxic relationship:

*Most of the conversations you have with this person end with you feeling unhappy, hurt, angry, put down, guilty, etc.  In other words, the person makes you feel bad more often than he or she makes you feel good.
*The person always seems to want something from you, be it money, a favor, a ride, to borrow something, etc.  Healthy relationships as a rule involve give and take.  In this relationship it's mostly about you giving and the other person taking.
*The person is rarely - if ever- there for you when you need something.
*The person is constantly criticizing you and putting you down.
*The person never expresses happiness for you when something good happens in your life.
*The person is frequently verbally or physically abusive to you.
*The person is always getting angry at you for reasons he or she refuses to share with you.  As a result, he or she often goes weeks without speaking to you because he or she is "mad."  Then, he or she tries to pick up the friendship or relationship right where it left off a few weeks later as if nothing happened.
*The person always seems to be in a crisis that he or she wants you to help fix.

These are just a few examples.  The point is, if you have a friend who resembles the descriptions I gave above you might want to ask yourself if it is healthy for you to maintain a friendship with this person.  There comes a point when the costs of maintaining certain friendships far outweigh the benefits.  When this happens it's probably time to think about ending the relationship.

Admitting You're Wrong

I've often wondered why it's so hard for human beings to admit when we're wrong and to accept constructive criticism from others.  I include myself in this.  I've had to work hard to learn to accept criticism without becoming defensive and still I catch myself wanting to explain it away when someone gives me negative feedback.  There's definitely ego involved.  There are times when we become so attached to our desire to be right that we don't even stop to listen to another person's point of view.  When insisting we are right or denying the validity of criticism we do it so vehemently that it almost seems as though we are fighting to protect our very identities.  And I think in some cases that's exactly what we are doing (or at least what we believe we are doing).

Identity is really only a collection of ideas each person has about him or herself.  Included in these ideas are beliefs about ourselves, beliefs about others, values that we believe we should adhere to, expectations we have of ourselves (and others) and our behaviors, etc.  Some people expect themselves not to make mistakes.  To admit to making a mistake is to admit that they aren't living up to their own expectations, i.e., that they are "not good enough."  Other people believe they should never show weakness to others.  They equate being wrong with being weak.  Thus, even if they know they are wrong they'd never admit it because to do so would make them seem weak and vulnerable.

The inability to accept criticism stems from self doubt.  Confident people accept themselves as they are.  They recognize that they have both strengths and limitations.  They accept that they are human.  Thus, when they are wrong they can admit it because they are, after all, only human.

The irony in this is that people who cannot accept constructive criticism are the very people who could benefit the most from it.  Criticism provides a person with important information about his or her personal weaknesses that he or she would probably not otherwise recognize.  This helps a person to identify areas for personal growth, which is, in my opinion, something we should all be striving for.

Gratitude

What does it mean to be grateful? Here are some thoughts:

*Gratitude means being thankful for what you have.
*Being grateful means not longing for more than what you have.
*To be grateful means not coveting what others have.
*Gratitude means saying thank you even for difficult experiences, as they generally have something to teach us.
*A grateful person is one who does not complain all of the time.
*Living a life of gratitude requires taking time on a regular basis to think about (or to write down) what you  have to be thankful for in your life.
*Practicing gratitude means recognizing that the good things in life are gifts that are bestowed upon you (rather than things that you earn or deserve). 
*A grateful person feels thankful for any opportunity to help others or to make the world a better place.
*To be grateful you must first let go of any and all sense of entitlement.
*Being grateful means not taking anything for granted.
*A grateful person is one who outwardly expresses his gratitude to others.
*Practicing gratitude means paying attention to all the "small" things we receive from others on a daily basis, such as service at the grocery store or post office, cooperation from coworkers, etc.

Just some things to think about...

Feelings as Habits

So I made it through the wedding and I actually really enjoyed myself.  When all the hubub died down I was emotionally drained.  During the days following the wedding I wavered between feeling exhausted, happy, anxious, and at peace.  When I first noticed myself feeling anxious I was confused.  Why would I be anxious?  After all, most of the excitement had died down and things were starting to go back to "normal" (whatever that means).  I did a brief inventory of what was going on in my life and ultimately determined that I had addressed everything that needed to be addressed and that there was not really anything in particular that I needed to worry about.  I immediately felt better after making this determination.  Still, several hours later I noticed myself feeling anxious again.  I did another mental assessment, determined that all was well, and again felt better.  I repeated this procedure several times a day.  After a few days it occurred to me that I'd been feeling so anxious for such an extended period of time (maybe starting two or three weeks before the wedding) that feeling anxious had become a habit of sorts.  My mind was simply resorting to the state to which it had become accustomed.  It took another week of reminding myself that I had nothing to be anxious about before my mind started to catch on.   

The fact that emotional states can become habitual is significant because I think that people often maintain a negative emotional state for no other reason than the fact that they've become used to feeling that way.  Research supports this observation.  Many studies have shown that, for example, feeling and expressing anger breed more feelings of anger.  Feelings of depression often lead to negative thoughts that create more feelings of depression that lead to more negative thoughts.  Any given emotional state is self-perpetuating,  In other words, feeling any given way becomes a habit.  When happiness breeds more happiness there typically aren't any problems.  When the self-perpetuating emotions are negative, however, they can be very disruptive.

I want to stress the importance of paying attention to your feelings.  Sometimes people interpret feelings of anxiety as a sign that something is wrong and they begin looking for things in their lives to worry about.  And of course if we look hard enough we can all find something in our lives to worry about.  The reality is that feeling anxious does not necessarily mean that there is, in fact, something to be anxious about.  That is why it is helpful to ask yourself, "Is there anything in my life right now that seems to be causing my anxiety?"  If the answer is no then recognize that there is no external cause for your anxiety and that it is most likely coming from some biochemical process taking place in your brain.  This gives you permission to stop looking for things to worry about...which is always a huge relief.

When Good Things Happen

I once did this self-help exercise that asked me to list the happiest, most exciting moments in my life.  That wasn't too hard to do.  Graduation from high school and then college were natural first picks.  I quickly made a list detailing my life's defining moments.  The second part of the exercise asked the following: "Which part or parts of you were present for each of these events?"  I put some thought into it and wrote down my answers.  As I looked over my responses I noticed something surprising; "Anxious Melody" was the only "part" of me that was present at every single event. 

So what does that say about me?  Well, it's pretty clear that whenever something big happens, whether good or bad, I feel anxious.  I'd say that this is probably true for change as well (i.e., whenever there is a big change in my life, whether good or bad, I feel anxious).  I don't think I'm unusual in this aspect.  Many people experience anxiety during periods of change and/or uncertainty.  What I think is sort of sad, however, is that anxiety is the predominant emotion I experience when good things happen in my life.  If you recall, the exercise I mentioned earlier asked me to identify the happiest, most exciting moments of my life.  One would logically assume that a person would feel happy and excited during these times.  But not me - oh no.  Me, I just feel anxious.

So what should I do about it?  Well, I've simply accepted it.  Some would say that it is simply not acceptable to feel anxious in situations where most people feel happy.  Some would say that it's a problem that needs to be treated.  I was first diagnosed with an anxiety disorder when I was five years old.  I've been developing ways to adapt to and cope with it for most of my life.  I've received treatment and have been taking medication to manage my symptoms for over ten years.  Most of the time I don't feel anxious.  This is an improvement for me and I am grateful for it.  And still, when big things happen in my life I feel anxious.  I probably always will.  I just try to cope with it in healthy ways and find hope in knowing that I'll get through the transition and the anxiety will eventually fade. 

I share this story for a few reasons.  For one, I think it is important to work to address and solve problems whenever possible.  When you've done all you can do, however, it is important to know when to stop fighting against what is and to simply accept it.  Secondly, I think anyone who has ever struggled with anxiety will probably be able to identify with some of what I've said.  And lastly, it's relevant to me at this particular point in time in my life.  I'm getting married on Saturday and my anxiety has been off the charts this past week.  So wish me luck...

America the Superpower

I don't talk about politics very often on this blog because I know it can be a polarizing subject and my aim is to bring people together, not to divide them.  However, given the recent midterm elections and the ever growing hostility between the two political parties I thought I should take a minute to reflect on the current political situation. 

The focus of the midterm campaigns was on the nation's financial situation, to include the economy.  This makes sense, given that so many people are unemployed (or underemployed).  People are worried about the national deficit.  They believe that our government is spending too much money and digging a financial hole that we'll never be able to get out of.  I'm not going to pretend to know the actual ramifications of an expanding deficit.  I'm assuming that at some point the taxpayers will be forced to pay for it.  I don't think anyone would argue that we should just continue spending and increasing our national debt without worrying about it.  The conflict arises over how to go about decreasing the deficit.

Now I'm no economist, but I have done a little reading on the subject.  From what I understand, there are two basic ways to decrease the national deficit: raise taxes (so the government takes in more money) or reduce spending (so the government spends less money).  Raising taxes is not popular.  No one wants to see more money coming out of their paychecks.  What about reducing spending?  Well, here's the thing.  A significant majority of government spending (and I mean a SIGNIFICANT majority) goes to pay for the following: Medicare, Medicaid, SSI, public assistance programs, and defense.  What politician wants to risk their career by proposing cuts to disabled people, uninsured children, or the military? 

So you can see the problem.  If we are to decrease the deficit in any significant way we have a choice between two unpleasant options.  Either raise taxes or cut government programs for some of our neediest citizens.  Or...reduce defense spending.

I work for the military and I support our service members 100%.  But here's something to think about.  What are our nation's priorities?  People say they want to decrease the deficit but they are not willing to give anything up in order to do it.  America is the only remaining world "superpower."  We need a big military so we can send troops all over the world to defend our way of life.  Or so goes popular sentiment.  I wonder though, can America really afford to be a superpower anymore?  I'm not saying we should cut our military down to nothing, but perhaps we could just mind our own business and let the world deal with itself.  That's not to say we shouldn't get involved in conflicts that threaten the safety of our country, but do we really need troops everywhere that we have them?  We have military bases all over the world in places where there isn't any conflict at all and hasn't been for decades.  Meanwhile, here at home, the economy goes down the tubes and we bicker about how to decrease the deficit.

It seems to me like our country has some hard choices to make.  The fact of the matter is, taxes are going to have to be raised, either now or later.  AND spending is going to have to be cut from places we don't want to cut it.  So what we really need to do as a nation is examine our priorities.  What is most important to us?  Where do we need to spend the most money?  Where can we spend less money?  It's just something to think about...

Self Destructive?

I recently read a short story by Stephen King called "Quitters Inc."  The story starts when the main character runs into an old friend at the airport.  The friend looks younger and fitter than ever and says he's making a lot of money working for some big corporation.  He tells the main character that his life turned around when he quit smoking.  When asked how he managed to quit he hands the guy a business card for Quitters Inc. and promises him, "They'll cure you."  The main character asks about the program used at Quitters Inc. to help people quit.  His old buddy refuses to say, stating that the contract he signed with Quitters Inc. has sworn him to secrecy.  The main character persists but his buddy won't budge. 

The next day the main character stops by Quitters Inc. after work.  The staff refuse to tell him about the treatment program but inform  him that he won't be charged a penny until he's been smoke free for a year.  The guy comes back the next day to begin treatment.  He shakes hands with the doctor and follows him down the hall.  "When does the treatment start?" he asks.  He is told that it already started - the moment he shook hands with the doctor.  It is too late to change his mind now.

Finally the doctor tells him about the treatment.  Our protagonist follows the doctor to a set of green curtains, which the doctor parts to reveal a window that looks into a room with a small bunny nibbling at rabbit pellets from a dish.  The doctor presses a button and the bunny begins to hop around.  His fur is standing out in all directions.  The doctor pushes the button again.  The bunny stops hopping and runs to the corner where he cowers fretfully.  The doctor proudly explains that if the bunny is "jolted" enough times while he's eating he will eventually learn that eating = pain.  He will then stop eating and ultimately starve to death while a bowl of food sits ten feet away.  "It's called aversion training," he explains.

The protagonist quickly changes his mind about the treatment and tries to leave, but it's too late.  Treatment has already started.  He is told that representatives from Quitters Inc. will be watching him daily.  If he smokes a cigarette, his wife will be brought to the "bunny room" and given a few jolts while he watches.  If he slips up again, he'll get a "jolt" himself.  A third slip up and he and his wife will be brought to the "bunny room" together.  A fourth time and his young, mentally disabled son gets a beating.  A fifth time and it's "jolts" for him and his wife and beatings for his wife and son.  The punishments get progressively worse until the tenth slip up, at which point the treatment (and the patient) will be terminated.

The main character lives in fear for a while but manages to avoid smoking.  Soon, his life begins to improve.  He starts spending more time with his son.  He gets a promotion at work.  He starts exercising and losing weight.

One day, while angrily sitting in traffic, he gives in to temptation and takes a few puffs from a cigarette.  When he arrives home he finds that his wife is not there.  Eventually, he heads to Quitters Inc. where he is forced to watch his wife endure a few jolts in the "bunny room."  Afterward, he has to explain to his wife what is going on.  He expects her to be angry and is surprised when she tells him that she's actually happy.  She tells him that Quitters Inc. is saving his life.

Anyway, the protagonist does not relapse again and goes on to lead a happy and successful life.

This story made me think.  It dawned on me that it does often come down to forcing a person to make changes that he or she knows are good for him.  A person might halfheartedly try to quit smoking only to give up a day or two later.  A person might say, "I know I need to start exercising" but never get around to it.  Someone might recognize that she is drinking too much but tell herself that she's young and she'll slow down when she gets older.  It often takes something big - a heart attack, the death of a loved one, a DUI - to get a person to actually make the changes that need to be made.  Why is this?  Why is it that people so often seem content to continue down a path of self-destructive behavior, even when they know it is not good for them or when they can clearly see that it is having negative consequences?  In the story, the character mentions that he's tried to quit smoking many times but has never made it longer than a few days before giving up.  Yet when he is placed under duress he is able to withstand temptation and only has one brief moment of weakness.  Why don't we have the motivation to make these changes on our own, without pressure?  Why would we rather do what's bad for us than what's good for us?  These are just some questions I started pondering after reading "Quitters Inc."  I don't have the answers, but would love to hear any insight other might have.   

Stop thinking!

American culture values rational thought.  We tend to admire those who are level-headed, who make logical, well thought-out decisions.  In fact, most of us would say that the "right" way to make decisions is by conducting a rational analysis of the risks and benefits of all available options.  "Good" decision making is an intellectual process.

Now I'll be the first to admit that it is typically less than ideal to make choices based entirely upon one's feelings.  In fact, emotions frequently interfere with judgment, rendering one incapable of making good decisions.

My personal belief is that decisions are best made using a combination of both thought and feeling.  This is what Marsha Lenehan, creator of Dialectical Behavior Therapy, calls the "wise mind."  The wise mind is the place where your rational mind and your feeling mind join in agreement.

So there are clearly times when it is beneficial to set your feelings aside in the name of good decision making.  I also believe, however, that there comes a time when it is best to set rational thought aside.  Consider this: most of us probably know or have known someone who we believe "thinks too much."  In my work I have encountered many patients who tell me they over-think things or that they can't turn their minds off when they want to relax.  Perhaps you can recall a time when you completely over-analyzed a problem or situation and ended up distressed or confused.   Clearly, it is possible to over-think things.  This can cause us to second guess ourselves, to look for meaning where none exists, or to become so overwhelmed by the sheer number of possible options that we become paralyzed and unable to take action.

I make this point as a reminder to myself.  I am one of those people who tends to think too much.  This inevitably leads me to question myself, my life, and the decisions I've made, which ultimately creates anxiety and self-doubt.  Of course, sometimes it is beneficial to examine yourself and your life, to identify where you can improve, to change direction, or to set new goals for yourself.  This is not, however, something that needs to be done daily.  Thinking too much about what I've chosen to do with my life just leads to insecurity and restlessness.  It prevents me from being satisfied with who I am and what I've accomplished.  There comes a time when it is best to just stop thinking - and enjoy living.