Friday, July 21, 2017

I'll just be over here, quietly bleeding: A personal story of miscarriage

Miscarriage is a strange word. One word to describe a litany of different losses. Any pregnancy loss occurring spontaneously during the first 20 weeks is considered a miscarriage.  Though the difference between week one and week twenty is unfathomable. At week 6 or 7 you miscarry a beating heart; by week 12, a face and tiny hands. Maybe it was "just" an empty sac that only took form in your mind. Or maybe you weren't either aware or excited to be pregnant when the cramping and bleeding set in.  Miscarriage-- it implies wrong doing, doesn't it? There's someone to blame when there's a miscarriage of justice, why not when a life or life ingredients are miscarried? It's cold comfort to many women that most miscarriages were predetermined by some ill-fated chromosomal abnormality. It wasn't the coffee, the anxiety, or that glass of wine you had before you saw the second blue line.

I was holding the bag of freebies from the prenatal nurse-- already, at week 7 feeling pressure to toss the formula samples and steel myself for another breastfeeding attempt. She had the pleasant, vacant smile of someone who has the same life-changing conversation with 8-10 women per day. Her face sank in to concern when I told her about the bleeding that had started that morning.

Then came the waiting-- waiting for an opening in the doctor's schedule for an unplanned consult, waiting for an hCG level that turned out to be inconclusive, and the eventual waiting for the likely intensification of bleeding that would seal the deal.

I wasn't prepared. I was sad, but also relieved. Our lives were so full and stressful at the time and I just couldn't see how we were going to manage a second baby. And then the guilt set in swiftly thereafter. My womanness was shaken to its seemingly shallow core by what felt like a heartless and unmotherly reaction.  And then finally, the authentic sadness, sadness that realized it had all been true. I had wanted another child and had been hopeful and joyful when we found out I was pregnant, but our lives truly could not handle another little one, no matter how much I wanted it.

After a couple of days of processing and trying make sense of all the feelings, judgments, and doubts, I felt ready to move on. My body, however was not ready. This is the part I really wasn't expecting. How do you deal with the loss of someone you've never met when the loss itself takes weeks, three weeks in my case, which was all I could tolerate before requesting a D and C? No funeral, no pronouncement of death marking the end and some new beginning. Just the alternating slow trickle or frightening rush of blood and tissue, day in and day out. The never ending rotation of sanitary pads, mild nausea from lingering pregnancy hormones, all constant reminders that you were, still kind of are, but soon definitely won't be: pregnant.

I was lonely, angry, feeling misunderstood and invisible to most everyone. Very few knew I was pregnant in the first place. I didn't know how to tell the people I trusted about the miscarriage. I hadn't HAD a miscarriage, I was HAVING one right then and there. And that felt a bit like announcing over dinner that I was having a heart attack.

Now that the D and C is done, and I am hopeful that my body will start to feel like a safe space and less like a burial ground. I realize that the thing I wanted most, the comfort I was seeking, wasn't a different outcome, but relief from the difficult and conflicting feelings. All that hurt and rage and doubt. Sometimes we need to be smacked in the face with pain to remember what it means to be human. That's the meaning I'm hoping will start to feel true eventually. Not yet, but soon.

Wednesday, July 12, 2017

Cultivating Gentleness: Resources for Incorporating Self-Compassion into Your Healing Process

During periods of turmoil and distress, it is easy to be hard on ourselves and let our fear and shame dictate our emotions, actions, and thoughts. If you’re like most people, it can be easy to fall into a trap of believing that we’re the problem and that if we only worked harder, planned better, made a different choice, insert your own “should” here, we would be experiencing less emotional distress and greater fulfillment.
Suffering is a part of being human. And being human is hard. It is easy to get swept away in futile attempts at perfection rather than allowing ourselves to be at peace with the reality that life involves suffering and darkness. It is then our job to do what Marsha Linehan, the founder of Dialectical Behavioral Therapy, refers to as  “bearing our pain skillfully” rather than pushing it away, avoiding difficult emotions, blaming ourselves, or succumbing to self-doubt. When we experience something that shakes us to our core, an attitude of gentleness and self-compassion is often the most helpful stance to promote healing.
What does it mean for you to be gentle to yourself? For some it may look like reminding ourselves daily that we’re doing the best we can. For others it may mean clearing your schedule in order to spend some time taking care of ourselves, creating more reasonable expectations, or setting helpful boundaries in relationships. Gentleness is the active, intentional choice to treat ourselves as humans deserving of kindness and love, whether we believe that about ourselves or not.
The following resources are designed to help you move away from a mindset of self-shaming and create more space for gentleness and self-compassion.
1)     Insight Timer – Guided Meditations for Self-Compassion: Insight Timer is a user-friendly meditation app that allows you to choose from a large selection of prerecorded guided meditations or use their timer feature to meditate on your own with the option to play various peaceful background noises (nature sounds, bells, etc.). “Five Minutes of Self-Compassion” by Lisa Abramson is a lovely and brief way to ground ourselves in lovingkindness and remind ourselves that we are all doing our best (Dr. Mowrey is also a contributor—check out her profile at

2)     The Gifts of Imperfection by Brene Brown -  Brene Brown’s research primarily focuses on shame, vulnerability, and worthiness. In The Gifts of Imperfection she calls readers to move away from our constant need to “perform, please, and perfect” and embrace our own imperfections and failures on the path to living a “wholehearted” life.

3)     The Mindful Path to Self-Compassion by Christopher Germer – Germer invites us to challenge our inner critic and take steps towards being more present-focused. This book provides a balance of practical mindfulness exercises, scientifically based research findings, and wisdom from Germer’s years as a therapist.

I hope these resources can be good jumping off points for creating a practice of self-compassion. What are other steps you can take towards cultivating gentleness towards yourself? Maybe it’s honoring your body’s physical needs with sufficient sleep, nourishment, and water. Or perhaps it’s rescheduling a social engagement for a time when you know you’ll have the capacity to be present and enjoy it.
I’d love to hear from you! How were you able to cultivate gentleness this week?
 Post contributed by: Kelsey Domann-Scholz, MA, LPCA
Creasman Counseling, PLLC

Friday, May 12, 2017

Finding Yes in a World of No

Frustrated, feeling small, annoyed before the conversation even starts, Claire is filled to the brim with the noise of her crying baby, the task of dinner and the weariness built up from a day of isolated motherhood.  She yells to her husband upstairs “If I don’t get some help down here, I’m going to lose my mind!” This is the first he’s heard about her need for help, but he feels guilty, a failure, nonetheless.  Another argument ensues.

When we become accustomed to not getting what we want, we begin asking from a place of “no.” Learned over a lifetime of being rejected, put down, or dismissed, this place of no becomes a way of seeing the world that is not a choice, but a fact of life. We are angry for not getting what we want before we’ve even put our request out there, and inadvertently lessen our chances of getting what we want through our ineffective asking style.  We ask with frustrated tones that trigger defensiveness in those around us, confirming our assumption that people don’t actually care about us, and the world is a place of scarcity.

In order to move out of this place of no, and in to our Yes Mind, we have to take a look at what the assumption of rejection is protecting in us. Sometimes we avoid asking openly, clearly, and effectively for what we want because deep down we doubt that we deserve it. Maybe I don’t ask for that promotion assertively because I imagine the new role would expose me for the charlatan I am; I’m lucky to have gotten this far without being found out.  We may also believe that the disappointment we brace for is somehow more manageable than disappointment that comes after our best effort is put forth with an open and hopeful heart. Regardless of the reason, in order to find our yes, we have to heal the wounds of no. We heal by acknowledging and accepting. In order to get yes from the world, I have to say yes to myself in my entirety. I see those places that need kindness in myself and offer love and acceptance to those places so that the world can follow suit.

If I recognize my fears and see how they manifest in the way I put my wants and needs out in to the world, I can then decide to take the risk of really transforming. Asking for change or for more becomes an exercise in abundance. I feel my value as a truth that goes deeper than my experience as a woman who is never taken seriously, a person of color who is denied access due to perceived dangerousness, a “poor” person who isn’t classy enough to belong. All of my experiences of no have within them the seeds of yes.

We can certainly learn skills for making effective requests, but if we don’t work with our no wounds, the success we get back will be limited—a mirror constantly pointed toward the space that needs nurturance. The path to your fullness, your success begins with healing the no and embracing your yes. I am a whole person, yes. I am an asset with a full purpose, yes. I am more than any no I have received, yes.  What yes is waiting to be fully realized through your healing?

Tuesday, March 7, 2017

Of Course: Facing the Challenge of Sitting with Difficult Emotion

Anyone who has spent any amount of time in meditation has likely encountered discomfort-- the discomfort of sitting in a forced position, the discomfort of wishing we were doing something more entertaining, the discomfort of being with raw emotion. Many of my clients have bailed on meditation altogether in the face of some of these difficulties, which led me to look at strategies for helping them through those tough times.

I spend a lot of time talking to my clients about compassion. For some the idea resonates immediately, comes naturally, and manifests in all kinds of positive ways quickly. For others, maybe most, compassion is at best a lofty idea that is hard to put in to practice and at worst, an experience that seems completely unavailable to us for one reason or another. Compassion is essential for healing, and is an incredible tool for increasing our discomfort tolerance so that growth can happen. In an effort to make compassion more accessible, we need to understand what it is and how to get our minds in on the task of opening ourselves with kindness and curiosity.

Compassion is essentially empathetic acceptance. I get in someone's shoes (possibly my own), acknowledge their reality, their perspective, and then without any push for change, I say lovingly and with a full heart "I feel that with you." The key to compassion is acceptance. What we are often experiencing in an uncomfortable mediation sitting is an absence of acceptance. We are so used to acceptance being followed by negative judgment that the notion of allowing our thoughts and feelings to arise just as they are feels defeating, draining. When we take the next step from acceptance in to compassion, we not only allow what is, but we also allow the impact of what is to be relevant. We interact with ourselves more gently, with more kindness.

Rather than keep browbeating myself in to being compassionate (because that would surely defeat the purpose), I've started engaging compassion on the sly, using the phrase "of course." When a difficult emotion arises that I feel the urge to turn away from or push down, I say to myself "of course I feel this way, and of course I don't want to feel this feeling." "Of course" has the flavor of logic about it-- the phrase gives us the sense that we have rationally come to the conclusion that something is inevitable, which acknowledges a fundamental truth of the universe that nothing comes from nowhere, so if something is, it must be. "Of course" then gives us permission to be kind to ourselves and to connect more compassionately with whatever is showing up in meditation. If a feeling is unavoidable, which "of course" would suggest, then I don't have to struggle with myself over its existence, and can instead use my energy to nurture myself through the difficult experience. "Of course" allows us to interact with mental and emotional difficulty as we would a physical injury. If you cut your finger and cry out, it would be easy to say "of course you are in pain, you cut your finger! Let's get a Bandaid."

We might also use "of course" to connect the dots between the experiences that have trained us to be avoidant, anxious, or judgmental and our current difficulty. Let's say I am struggling to sit with negative self-judgment. In meditation, I seem to constantly berate myself for not sitting long enough or for getting distracted. If I can make those judgments the object of my attention, I might create just enough room to ask "where is that coming from?" Maybe my early caregivers were very hard on me any time I made a mistake, or perhaps I grew up in a dangerous place where any misstep could end in violence. Regardless of the cause, if we open ourselves up enough, we get to the "of course." Of course I'm critical of myself, because I've been trained to be that way. We use this not to pass the buck of our suffering, but to allow for the reality of difficulty without writing ourselves off as failures. 

Next time you are struggling to sit through something uncomfortable, try opening yourself to the power of compassion by telling yourself gently "of course."

Saturday, September 10, 2016

Deconstructing Defensive Pessimism

Have you ever told yourself something along the lines of "it will definitely rain today since I just got my hair done," or "I'll probably hit every red light in town since I'm running late?" These seemingly benign thoughts are the seeds of defensive pessimism, and a major barrier to joy.  Defensive pessimism is about predicting negativity as a protection against disappointment or pain.  My husband is probably going to leave me some day, so I should probably think about how I would support myself.  Going back to school would just leave me in the same cut-throat job market with more debt, so why bother? There are kernels of practicality in these statements, so we feel justified in our acceptance of them.  But these negative narratives disempower us, separate us from joy, and can actually work against our goals.

We have our understanding of strength all backwards.  There was actually an episode of Bones where Temperance Brennan (main character, forensic anthropologist, I watched a lot of TV while pregnant) says that her relationship with her partner has changed her from an impervious substance to a strong substance.  Impervious substances are not responsive to the forces acting upon them, and as such remain separate and isolated.  Strong substances are in flow, allowing for the natural processes of change, growth, decay.  Personal strength requires this same allowing, built on the confidence that any negative feeling or experience can be tolerated without fear of coming apart.  Defensive pessimism uses negative forecasting to protect us from future pain, but for it to "work" we have to also buy into the story of our weakness.  Defensive pessimism insists that our ability to brush up against loss, rejection, disappointment is bounded.  Our heart and mind, the space of our experience becomes smaller and smaller as we fill it with fear and doubt.  The truth of our potential cannot be actualized when we quit before we start to avoid the pain of failure.

"I'm not a pessimist, I'm a realist." That is the mind's way of acting on fear by convincing us that it is somehow more legitimate or accurate to live in worry and fear.  When we imagine a negative future in the service of "realism" we aren't getting any closer to the truth, and are actually distancing ourselves from joy.  To truly assess the future from a realistic standpoint, we would have to acknowledge that we have no idea how things are going to go down-- meaning that worry and hope are equal in their predictive uselessness.  We would have to lean in to groundlessness, and often the pain of uncertainty seems far greater than the pain of a negative outcome.  What we fail to see, because our fearful minds get in the way, is that we experience the story of loss the same way we experience actual loss.  We can't feel our feelings in advance and get them over with, but we can double our dose of pain by imagining negative outcomes.  The cost of this pain preparation is that we disconnect from presence, from our non-judgment, from our pure, unedited experience of right now.  Eckhart Tolle has boldly said that there are no problems in the present moment, and while I initially bristled at this (well, he sure hasn't experienced my present moments then), eventually that truth worked it's way in. The stripped bare present moment has no goodness or badness attached to it like the calm still lake before the fish jumps or the moment before the gun goes off to start the race.  Even if our defensive pessimism doesn't stop us from making changes or taking risks, it hijacks our peace of mind and limits our capacity for happiness in each moment.

Defensive pessimism does its worst work when disguised as flexibility.  I recently asked a client what she wanted in a partner and she began her answer with "I would be ok with..."  I stopped her right there and more forcefully told her not to tell me what she would be ok with, but to say out loud what she wants.  I was feeling particularly stuck with another client who was struggling to find work with a disability and realized that we weren't getting anywhere because we didn't know where he wanted to go.  Asking him to connect with what he truly wanted from his life felt like too great a risk because he was so used to being disappointed in his efforts toward any goal.  What I have learned from clients and from my own experiences of lowering my standards to accommodate what I felt was possible or worse, what I felt I deserved, is that we will not embrace our best selves by settling.  It's not always easy to know the difference between being openness and defensive pessimism.  I know I'm being open when I change my expectations with a clear and non-judgmental mind.  I know I'm being defensively pessimistic when I feel the air go out of me, my shoulders slump, and my mind starts to tell me stories about how I shouldn't have wanted so much anyway.  We aren't going to always get what we want, and there's no object or experience out in the world that carries the full weight of our happiness.  But we can connect with basic goodness by acknowledging our basic worthiness to ask for what we want.  Defensive pessimism whispers "you may as well not even think about what you want because you are too broken, too undeserving, too unimportant to even ask for it."

Just for the next week, try noticing all the ways defensive pessimism shows up in your own life and you'll uncover important information about where your heart may need to soften to let go of some fear.  The hardness of defensive pessimism does nothing to protect us from pain, and ends up protecting us from our own potential for joy and meaning. 

Thursday, August 18, 2016

Values-based goal setting

Our American culture loves to set some goals.  Television shows like The Biggest Loser encourage us to set (unrealistic) weight loss and fitness goals.  Bosses set performance goals and our kids strive for academic success measured by standardized testing and graduation rate goals.  This society is infatuated with achievement and progress, for better and worse.  Many of my clients decide to start therapy because they are struggling to meet health, relationship, or general life goals and until recently I took the same approach to everyone-- define the goal, determine how the goal will be measured, identify barriers and resources, and set a deadline.  When deadlines rolled around, the results were mixed.  Some had done what they set out to do and felt a sense of mastery, while others had missed the mark and felt disappointed and ineffective.  So I've changed my strategy.  Rather than helping clients set concrete, rigid goals that require will-power to be met, I now focus on values-based goals that are inherently flexible and more manageable.  Let's talk about rigidity, will-power, and values.

I was having a conversation with my husband about the most recent results of some swim meet at the Olympics.  As we were discussing who won what, I realized that I was separating the contestants into those who won (got the gold) and those who lost (everyone else).  If you've seen Talladega Nights, you're familiar with Ricky Bobby's mantra, "if you're not first, you're last."  I realized how bought in I was to this all or nothing approach to goals.  We decide on a specific outcome-- winning the gold, weighing a set amount, running a set distance in a specific amount of time-- and then any other outcome becomes unacceptable-- a failure. It's easy to see how this approach is ultimately setting us up for perceived failure most of the time and robs us of the opportunity to celebrate the process of change.

So what about will-power?  The will-power delusion asserts that I just have to want something bad enough to make it happen.  The self-defeating converse is where the problem lies-- if I didn't achieve a goal, it's because I didn't want it bad enough.  I don't know anyone who set a weight loss goal or a substance use reduction goal who didn't want to be healthier with their whole selves.  By insisting that the only barrier to success is a lack of will-power, we automatically short circuit problem solving efforts to manage the more likely barriers such as lack of skill, worry thoughts, emotions, indecision, or environmental challenges.  Will-power is a useful element in the early stages of goal attainment, when motivation is running high, but it will not always be available to us in the same quantity.  Will-power is essentially a combination of the emotions determination and motivation, but like all emotions, determination and motivation will wax and wane due to all sorts of other variables, many of which are out of our control.

"If I'm not using will-power to meet specific goals, then what am I supposed to do?" A values-based approach allows us to be realistically flexible in our goal setting, and avoid the will-power trap.  Before committing to a goal, it's important do some introspection to identify the value driving that goal.  For example, I have been less than happy with my weight since turning 30, and have typically tried to manage my weight by using food guilt and inflexible standards to motivate me to exercise and eat healthily. It wasn't until recently that I more deeply considered the "why"of this goal.  When I checked it out, weight loss is about being strong, capable, and healthy (with a sizeable portion of acculturated beauty standards), but my rigid weight goal was conflicting with values of being compassionate and accepting of myself.  So now I'm working toward weight loss (with help from Weight Watchers) as a function of my deeper values.  If I plan to run 4 miles, but end up running 3, rather than berate myself for a failure, I view my 3 mile run as a success given that I made that choice out of compassion for my sore hamstrings or in recognition that it's 100 degrees outside. Instead of deciding that health is about exercising a certain amount everyday without exception, I act in the service of health and broaden the choices that are consistent with this goal.  Flexibility helps us to honor the willfulness that shows up to let us know that a choice does not match the needs of the moment.

Ironically, the more flexible we are with ourselves, the more emotional, mental, and physical resources we make available for attaining our goals.  We stop wasting precious energy on guilt, shame, and self-degradation, and can channel those resources toward our goal work.  We stop trying to make the moment match our goals, and allow our goals to match the moment.  Here are some tools for assessing your values, identifying meaningful goals, and using a flexible mindset to be your best self.  Remember: more of our life is spent in the process than in the outcome, so learn find joy in the ride.

Friday, July 29, 2016

Practicing patience in tumultuous times

It seems this political season is charged with an uncommon level of conflict and anger.  Maybe I've just reached that magical age when new music sounds awful, I am never without an umbrella, and politics seem incredibly relevant.  It feels like more than maturation, though.  We seem to have reached a social boiling point that I can only hope results in a more unified and compassionate world.  I am absolutely not here to back any particular candidate, but I would like to talk about practicing patience in the face of anger; for working with the energy of anger so that we can make our best choices from our best selves.

The Dalai Lama talks about practicing patience in his book Healing Anger.  He very pragmatically suggests that to work with anger, we have to be skilled in its opposite-- patience.  I don't know about you, but I probably heard "be patient" a thousand times growing up, but no one ever told me how.  As a child, patience was synonymous with waiting, as if there were any other choice but to wait when dinner wasn't ready, or Christmas was still 2 months away. The Dalai Lama provided these step by step instructions:

1) Develop enthusiasm for patience by deeply acknowledging the destructive nature of anger. 
2) Practice patience toward mild discomforts so as to be prepared for more challenging situations.

Many of us rely on anger to feel powerful and effective. The energy of anger is useful, the actions of anger are not.  I personally have never acted on my urge to yell at someone, throw something, or punch a wall without some amount of regret.  Even if I felt some mild satisfaction at first, ultimately, acting on anger has left me feeling out of control, embarrassed, and small.  So what does it mean to say that the energy of anger is useful?  Consider the civil rights movement that continues today-- if no one were angry about the unfair treatment of people of color, change wouldn't have happened.  Yet many of those angry people demonstrated peacefully, calling calmly for change.  They used their anger to motivate effective, non-destructive action.  Anger can be the fuel that gets the car going, but it doesn't have to dictate the destination.  When we recognize that acting in anger creates more harm than good, and only serves to increase our negative emotion, we can lean wholeheartedly in to patience.

Just like you wouldn't want to learn CPR at the scene of a car crash, patience as a skill must be learned and practiced for mild discomforts.  We ultimately practice patience by saying yes where anger says no.  Anger tells us that a situation is unacceptable as it is and fights against a painful reality rather than accepting it.  You can't fix a problem you refuse to see, which is why acting in anger is so often ineffective-- anger characteristically refuses to accept what is.  Patience is accepting a painful reality.  If patience could speak to us it would say, "yes, this traffic is moving too slowly for you to get to work on time, and there's nothing to be done about that, so let's watch those negative judgments about how terribly unfair this is without clinging to them, and allow this moment to pass."  When we practice patience for minor problems like traffic jams, we increase the likelihood that it will be available to us when we find out our child is smoking marijuana, or when we see an incendiary post defaming our candidate of choice.  Patience allows us an opportunity to channel the energy of our anger into actions that are based in compassion and kindness.  Instead of telling that so-called Facebook friend how stupid they are, patience creates the space for real listening, real connection, and increases the chances that our actions will have a positive impact rather than deepen division.

When all else fails, when anger has moved our minds towards plans of spiteful, defensive action, FREEZE.  The more mindful we become of our triggers to anger, the more time we will have to interrupt the process of experiencing an event, judging it negatively, feeling our anger, and acting rashly.  We don't have to be levitating, enlightened monks in order to stop ourselves from slamming that door or hardening our hearts.  We just have to become aware and be willing to take three breaths when anger arises.  Freezing and breathing helps us get back in to contact with the moment and out of the story of our anger.  Patience allows us to interact effectively with our anger instead of being pushed around by it.  Patience makes room for our compassion.

"Genuine compassion is based on the rationale that just as I do, others also have the innate desire to be happy and overcome suffering; just as I do, they have the natural right to fulfill this fundamental aspiration.  Based on that recognition of this fundamental equality and commonality, one develops a sense of affinity and closeness, and based on that, one will generate love and compassion.  That is genuine compassion (Dalai Lama, Healing Anger)."