Originally published at Psychology Today Have you ever felt anxious about an upcoming talk - one whose outcome you can’t predict? One that makes you feel edgy or jittery all day, unable to focus on other things? Maybe you were planning to talk through something difficult with someone important - perhaps the status of your relationship, your reaction to a betrayal, or your apology for breaking a promise. You have to tell a parent that you won’t be able to visit when they want you to. You need to ask your partner to change the way they’ve been treating you. Or maybe it’s much more mundane: Your child got into a fight at school and you need to talk to them, to help them understand what went wrong. No matter what the purpose of the upcoming Big Talk, some things don’t change, and some communication strategies can almost always help. Here are seven basic ideas, elaborated where possible, about how to keep your difficult conversations open, clear, directed, and productive. Read the full article at PsychCentral

Originally published at Psychology Today Anxiety is miserable. And most people reach for a pill or push it away to reduce it. But if we think of anxiety as a signal or as the tip of an iceberg, we can take steps to more permanently ease it. Anxiety tells us deep biological programs called core emotions have been triggered out of conscious awareness. These core emotions are designed by evolution to be felt and expressed. When we push them away, we feel anxiety. Learning about core emotions and how they work in the mind and body is the most important thing we can do to change anxiety. Tools like the Change Triangle guide us to name our core emotions. Emotional conflicts can be more effectively dealt with when we can identify and work with the underlying divergent emotional experiences. What follows is an explanation of two techniques I teach my psychotherapy clients and participants in the Emotions Education 101 class I teach:

Technique #1: Identify both sides of your conflict and speak them in your mind with an "and" instead of a "but." For examples:

I love you AND right now I’m so angry at you that I feel like I hate you. I feel sad AND happy. I am depressed and I know I am lucky in many ways. I am lonely AND I prefer to be alone. Summary: Name and validate when you have anxiety, look for any underlying conflicts, validate each side of the conflict with an "and" instead of a "but." Notice how that feels. Click here to read the full article

Originally published at PsychCentral.com Research shows there may be a link between COVID-19 and the symptoms of depression. Here’s why it happens. Whether you’ve lost a loved one to COVID-19, experienced financial difficulties, or had a hard time adjusting to all the changes, the pandemic likely impacted you in some way. If you feel like you’re living with depression resulting from all of this, you’re not alone. Between 2020 and 2021, diagnoses of anxiety and depressive disorders jumped from 36% to 41%, according to the Centers for Disease Control and Prevention (CDC). But are these symptoms of depression a result of external factors only, or is depression a residual effect of the disease? So far, the research is pointing toward both.

Mental health symptoms of COVID-19

Scientists are learning more about the new coronavirus every day. But, for now, there’s limited information about the long-term effects of COVID-19. But there’s some indication that there may be a link between the disease and symptoms of depression. One study suggested that the coronavirus indirectly creates blood clots, which can cause brain damage. Another study suggested that our body’s immune system could indirectly be injuring brain cells while fighting the virus. Indeed, increased inflammation in the body is linked to depression. The coronavirus’s effect on the brain increases the risk for mental health challenges. About 1 in 5 people will develop a mental health condition 14 to 90 days after being diagnosed with COVID-19. For 5.8% of patients, it will be their first one. Mental health symptoms that developed as a result of COVID-19 also seem to persist 6 months after recovery. There also appears to be a link between COVID-19 symptoms and common symptoms of depression. For example, the loss of taste and smell were associated with depressive and anxiety symptoms. More recent research is starting to link depression with COVID-induced headaches. For example, a study published this year found that people with COVID-19 were at a higher risk for depressive symptoms when they reported headaches. Depressive symptoms were also more likely among younger adults than older adults. Read the full article

Originally published at PsychCentral.com Gaslighting can cause intense self-doubt, no matter who's doing it. How can you respond to this behavior? Gaslighting is a form of manipulation that can cause you to doubt your memory, opinions, and even your sanity. It's a tactic some people use to gain power and control over others. Romantic relationships aren't the only situations where gaslighting can occur. It can also happen:

• in a parent-child relationship
• in the workplace
• between family members

On a larger scale, political and authoritative figures have been known to gaslight entire societies. Research suggests that gaslighting behaviors can be rooted in gender and social inequalities. It tends to be common in intimate relationships where there's a power imbalance. It often happens gradually, as well. So you might not realize you're dealing with gaslighting until you begin to wonder why you're experiencing so much confusion, anxiety, and low self-esteem. If you've been experiencing gaslighting for a while, you might start to feel depressed, helpless, and indecisive as a result of the manipulation. One thing to remember in this cloud of confusion is that gaslighting is a form of psychological abuse — if you've experienced gaslighting, it's not your fault. And you're not the only one. Data from the Centers for Disease Control and Prevention (CDC) Trusted Source suggest that more than 43 million women and 38 million men in the United States have experienced some type of psychological abuse or aggression by an intimate partner. But how can you tell if someone is gaslighting you, and is there a way to confront it?

Read the full article

Re-posted from an article by Deborah Fox, M.S.W. How to manage difficult emotions may seem counterintuitive to many people. We humans don't like to be uncomfortable or in emotional pain. How many times have you been told or tell yourself the following:

• "buck up."
• "don't wallow."
• "move on." 
• "don't feel sorry for yourself."
• "think of how many others have it worse than you."

Plenty, I'm sure. The conventional wisdom of our culture is full of "think positive thoughts." The problem is that this wisdom doesn't chart the path we need to follow to that end. The answer to managing difficult feelings, we have to feel them before moving on and regaining our optimism and good cheer. This isn't easy. What may become common parlance, "oh, it's a total 2020," meaning a downer, things couldn't get much worse, is indicative of what many of you are experiencing. We are still in the middle of an uncontrolled pandemic, climate change, and political conflict. How can you not feel sad, or worry, or despair some days? Maybe your distress isn't about current times. Perhaps you struggle with a host of other uncomfortable feelings such as feeling unimportant, insecure, or anxious on an ongoing basis. For many people, the stress of what's going on in the world now exacerbates those feelings.

Managing Positive and Negative Feelings.

Our emotional system is not designed to feel positive feelings only and remove negative ones. That would be nice, but it just isn't so. To find our joy in simple pleasures and with those we're most connected to, we also have to feel our way through the tough ones. The key is to build your tolerance for feeling these difficult feelings and turn towards each other for connection and support. We are social creatures, and we need each other to go through the middle of turmoil to come out the other side.  Tuning into these difficult feelings will inevitably make you feel more vulnerable simply because you will not push the discomfort away. This is a challenge because feeling more vulnerable is uncomfortable, too. However, it's in that state of vulnerability that you can truly connect with another human being. You'll feel less alone, and you can walk through these uncertain times together, rather than just coping in separate silos.  There are moments--- milliseconds that you can grab before they slip away. These are the moments when you can identify that you're feeling down, worried, or despairing. When you're trying to "move on" or distract yourself, you'll find yourself feeling more and more blah or irritable---the perfect hiding places for vulnerable feelings. If you succeed in identifying that you're feeling sad or anxious at the moment, sit there with it. "Sitting with it" means naming it, feeling it, and not allowing yourself to prematurely make it go away by distracting yourself or starting an argument with a loved one. You will feel uncomfortable and vulnerable--- take a deep breath and stay there in that feeling. This sitting with the uncomfortable feeling allows you to know what affects you that you lose touch with when you shut down on the feelings.

Uncomfortable Feelings Have a Lifespan. 

It might be five minutes or five hours, and it may come and go. It's sitting with the feelings that allow you to build your tolerance for feeling vulnerable. You build it slowly, bit by bit. The more tolerance you have, then you can allow its life span to run its course. If you distract yourself by grabbing your phone or turning on the TV, it'll just go underground and lie in wait to ruin your mood for days on end.  Sitting with the feeling allows you to express, usually in a way your partner, or a close friend, can hear and empathize. Their ears open when they listen to you speak from that place of vulnerability. Feeling this connection is what can most alleviate the intensity of the discomfort. It won't make the pandemic uncertainties or anything else go away, but it can allow you to feel less alone. Feeling less alone goes a long way to walking through any crisis feeling stronger. Shutting down or arguing happens so easily because it's a momentary relief from the discomfort. The energy of arguing or the numbness of withdrawing doesn't feel great either, but it can be preferable to feeling vulnerable.  If you're already angry or withdrawn, ask yourself, "what else am I feeling, or what was I feeling earlier?" Maybe not immediately, but this question will allow you to pinpoint what feelings are hiding just below the surface. You know you're irritated, but you might be able to identify that you were anxious before you got annoyed. Then you can choose to sit with the anxiety.

Difficult Feelings are a Normal Part of Life. 

This is always true, but these uncertain times are causing tremendous turmoil and challenging our usual coping ways. What's critical is not to allow these feelings to overwhelm us. We're outside of our comfort zone, and we need to grow that zone to go forward and be able to grapple with what comes our way. We can't do it alone. Turning towards one another will serve us well and allow us to come out the other side to experience joyful moments amidst uncertainty.

Originally posted by Sharon Martin, LCSW Any long-standing pattern of behavior can be hard to change. We’re creatures of habit and tend to repeat the same behaviors over and over, often without even thinking about them — and sometimes we continue even when these behaviors create problems for us. This is the case with codependent behaviors.

What are codependent behaviors?

When I talk about codependent behaviors, I’m referring to things like enabling, perfectionism, self-sacrificing or martyrdom, obsessing about other people’s problems, trying to fix, change, or rescue others – even if they don’t seem very interested in changing. As codependents, we struggle to ask for help, we don’t prioritize our needs (so we get tired, irritable, resentful, and stressed out).

How do you change codependent behaviors?

Even though these behaviors are second-nature to us, we can change! The challenge, of course, is figuring out how to change. What do we do instead of these codependent behaviors? And how do we stick with the new behaviors long enough to see a difference? The answer is lots of practice and lots of self-compassion. Like any new behavior, we need to do the new behavior many times before we master it and feel comfortable doing it. At first, it will feel awkward, scary, guilt-ridden, and uncomfortable. In short, you’re not going to do it well! That’s where the self-compassion comes in. Give yourself credit for trying. Praise yourself for taking baby steps even if they don’t seem to accomplish much at first. Encourage yourself by saying things like, “You can do this!” Don’t expect perfection and try not to criticize yourself if you slide back into old behavior. This is all part of the process – I promise. So, let’s get started with some ideas for changing codependent behaviors.

People-pleasing

Instead of saying yes to every request, doing things you don’t want to do, or doing things out of obligation, consider what you need and want. Ask yourself:

• Am I interested in doing this?
• Why am I saying yes?
• Do I have time for this?
• Can I afford to do this?
• Does this align with my values and priorities?

Remind yourself that you’re allowed to say no. Some people may be disappointed or upset with you, but that is their problem, not yours. You are not responsible for making everyone happy. Action: This week, practice saying no to one thing that you don’t want to do, that doesn’t fit in your schedule or budget or doesn’t interest you, etc.

Acting like a martyr

A martyr is someone who insists on doing everything themself. You refuse help if it’s offered. But you’re not doing or giving joyfully. You’re resentful that you have to do so much and that people don’t help you or think about what you need. Action: The next time someone offers to help, say yes. Or if no one offers to help in the next week, ask. Simply say, “Can you please help me with _______?” They may refuse, but learning how to ask is still a success.

Lack of boundaries or being passive

Instead of letting others mistreat you (say mean things, borrow money without repaying, leaving a mess and expecting you to clean it up, violating your boundaries), set limits by telling people what’s not okay and what will happen if they continue. Action: When you feel mistreated, communicate how you feel and what you want or need using an I Statement. For example, “I feel hurt and offended when you make sarcastic comments about my weight. I’d like you to stop commenting on my appearance.” And if you think it’s helpful, you can also state what the consequence will be if they continue. It might sound like this: “And if you continue, I’m going to go in the other room and watch TV by myself.” When setting boundaries, remember that you can’t force other people to do what you want, but you can change your own behavior to keep yourself safe.

Enabling and fixating on other people’s problems

Enabling is something you do that allows another person to continue in a dysfunctional pattern. It could be pouring out their alcohol, calling in sick for them, cleaning up after them, giving them money. It can seem loving, but it really just allows them to avoid taking responsibility for themselves and from experiencing the natural consequences of their choices. Instead of enabling and focusing on what others are doing, take care of yourself and find healthier ways to manage your worry and anxiety. Often, we focus on other people not just to be helpful, but also because it gives us a sense of control (which helps us feel safe and quiets our anxiety), a feeling of being needed, or a distraction from looking at what we’re contributing to the problem and changing ourselves. Action: Identify your enabling behaviors. When you feel compelled to act on them, step away from the situation. Notice your feelings (see above) and think of an activity that you can do to comfort yourself, calm your fears, and tolerate the anxiety of letting your loved one experience the consequences of his or her actions. This could be calling a friend or sponsor, writing in a journal, taking a bath, exercising, meditating, praying, going to an Al-Anon or Codependents Anonymous meeting, playing with your dog, etc. Make a list of activities that you might try, so you have it ready when you need it! I hope you’ll try some of these action items this week!

Originally posted at Beacon Lens The holidays are upon us, and the irony they bring is the potential for isolation and loneliness. Holidays’ essential identity is getting together with loved ones, but some people do not feel as connected as they would like or expect. In 2020, add COVID-19 and its quarantining dictates, and the potential for such feelings can strengthen. The holidays, therefore, present an excellent time to discuss how we can reinforce connections during a time that requires us to be apart to protect our physical health, a requirement that paradoxically can have a damaging effect on our mental health. We can, however, take charge of improving our mental health.

Loneliness and isolation and our health

What is the difference between loneliness and isolation? “Loneliness is the feeling of being alone, regardless of the amount of social contact,” according to the Centers for Disease Control and Prevention (CDC). Social isolation, on the other hand, is a lack of social connections. Put differently, one can have many social connections but still feel lonely. The physical and mental health risks of loneliness and isolation are significant. They include but are not limited to:

• Social isolation increases the risk of premature death by 29 percent, rivalling smoking, obesity and physical inactivity.
• Social isolation is associated with increasing the risk for dementia by approximately 50 percent.
• Loneliness is connected to higher rates of depression, anxiety and suicide.

A 2020 report by the National Academies of Science, Engineering and Medicine (NASEM) states that more than one-third of adults 45 and older feel lonely, and approximately one-fourth 65 and older are socially isolated. Add the holidays and COVID-19 to an already preexisting condition, and the time is ripe for all of us to take action to protect our mental health.

Simple steps for better mental health during the holidays

Specific to the season and the times, there are common-sense tips that we all can practice to help manage loneliness. For example:

• Talk to someone about your sense of loneliness and isolation. There’s stigma around loneliness so it can be hard to do. However, you may well find that you’re not alone in those feelings, and sharing them can help lessen their effect.
• Manage your holiday/COVID-19 expectations. The holidays can fall short of expectations, but this year it may be worse. Understand that the pandemic won’t last forever, and that we’re all in this together. Indeed, many people’s holiday gatherings will likely be different this year.
• Remember to take care of yourself, now more than ever. Sleep, exercise and good nutrition — with the proper amount of holiday indulgence — go a long way in addressing mental health.
• Avoid social media, such as Facebook or Instagram, especially during the holidays. It’s easy to negatively compare one’s life to the “perfect” lives posted on social media, forgetting that people mostly post only the positive.

Loneliness and isolation as its own pandemic

The holidays don’t last forever, and we will get through the COVID-19 pandemic. However, loneliness and social isolation may persist, which presents a challenge for behavioral health providers. The recent NASEM report explores interventions that the healthcare system can take to address loneliness as a societal condition, such as engagement in support groups, cognitive behavioral therapy and mindfulness, social determinants of health, social prescribing and more. Social prescribing is arguably one of the more interesting interventions in that it puts a clinical lens on non-clinical solutions. While there is no hard-fast definition of social prescribing, it is generally accepted as a way to connect people to non-clinical sources of support, according to the NASEM. Specifically, it is a “non-medical referral, or linking service, to help people identify their social needs and develop wellbeing action plans to promote, establish or reestablish integration and support in their communities, with the aim of improving personal wellbeing.” Examples of secondary services that improve social concerns affecting health include housing and food insecurity services. While known to varying community-based organizations, social prescribing is not common among practitioners, but it’s a common-sense solution. An analysis of one pilot program from the NASEM report — albeit a small one — found that social prescribing reduced inpatient admissions by as much as 21 percent and emergency room visits by 20 percent. A modern world — without COVID-19 — is more connected than ever due to social media and other technology. However, studies have shown we are more lonely now than in any other time in recent history. It’s time to think out of the box as we realize more and more how non-physiological conditions — such as issues ranging from a public health emergency to social media — can affect our health.

Originally posted at ImagoRelationshipsWork.com Falling in love and staying in love both require giving a part of yourself away, but healthy love is not demanding or uncompromising.

• Healthy love allows you to be your best self and socialize with colleagues, friends, and family.
• Healthy love is not controlling or dependent.
• Healthy love is ever-changing and growing in subtle ways.
• Positive love encourages and is kind and thoughtful of the other. It is honest and supportive.
• If you are in love with someone who requires you to alter your personality, goals or wants you all to themself, this is not healthy.
• If you are staying in a relationship purely because you are afraid of being alone, this is not real love.
• When either of the partners in a relationship is always controlling or untruthful, this is unhealthy.

In a healthy relationship, communication and honesty are vital players.

There is lots of trust and little room for jealousy. Jealousy is a tricky emotion. It can fool people into thinking - "He must love me because he is jealous." Unless your partner has given you a reason to feel jealous, for example, he/she is a chronic liar, has been caught cheating, you should be able to manage your jealous feelings. It's normal to feel a twinge of jealousy on occasion. If you are experiencing jealousy 24/7, you need to look into the reasons. Often jealousy is a sign of insecurity or lack of knowing and accepting yourself. Healthy love includes loving yourself, as well.

If you are obsessed with the person you love and have no interest in spending time with anyone else, that is not healthy.

Most of us want to spend a good portion of our time with the person we love, yet there needs to be a balance. Each of us needs to cultivate friendships that are healthy, genuine, and interesting. Obsessive love is all-consuming and is based on negative emotions such as fear, jealousy, anxiety. In healthy relationships, you can disagree without fear of the person leaving or retaliating. It is not normal or healthy to feel you have to be agreeable all of the time, or else. Loving another is about the give and take. Lopsided love is unbalanced.

When two healthy people are in love, their relationship does not wholly define them.

You want to be developing yourself, both interior and exterior. If all of your self worth is wrapped up in your relationship, this is not healthy. Partners each bring something to share at the table. If you have neglected yourself, it is time to rediscover who you are as an individual. Develop your likes and passions, give yourself credit, take risks, and make changes that are important to you. “A healthy relationship will never make you give up your friends, your dreams, or your dignity…” Dinkar Kalotra.

Be honest with yourself when it comes to your love relationship.

• Is it healthy, or does it need modifying?
• Is there mutual respect?

Remember, too, that no relationship is perfect. It is often about loving through imperfections and knowing the difference between healthy and unhealthy love.

These are trying times. Our lives have been upended. We’ve been mandated to stay at home and work from home; our social outings have been drastically reduced, as have our social interactions with others. We’re faced with 24/7 interaction with our partners. The result is a unique form of cabin fever, which when combined with the stressors of an invisible enemy), (covid 19) creates profound uncertainty (When will this end? How? Will it return? Will I or my loved ones get sick?), major changes to our routines, and economic concerns, and becomes a stressful burden on even the happiest couples. These are times that call for our best—but how can we be our best when the natural human response is an uptick in anxiety and/or depression levels? Most of us have “COVID-brain”: It’s hard to think clearly when we are so worried and scared or feeling like molasses from our blueness. There’s just too much going on! We’re living in unprecedented times, locked out from the outside world and somewhat locked out of ourselves; we are unable to digest and reflect. This lessening of our cognitive function can impact our ability to ride the choppy waves in our couple relationship. Cindy Baum Baicker PhD,a clinical psychologist, interviewed senior psychoanalysts and described 5 factors which can be guide posts for couples during this stressful period. Pragmatism: Now is not the time for minor irritations. Let things go.  If you have had some alcohol and are annoyed or angry at your partner, let it go and if you’re still angry the next day, bring it up for discussion. We’re myopic when we drink, and nothing good can come from conflict resolution when we’re in an altered state. Think existentially: Who do we want to be when all of this is over? What will it have meant for us? Balanced Paradox: We’re separate, and we’re attached. Allow for each of these realities in your relationship. Make space to spend time together and apart, even though you’re living in the same space. Cognitive-Affective Differentiation: Allow for difference! A couple’s resilience during this time will depend on the state of the two people who are in the relationship. Stress affects each one of us differently and we each cope differently. Affect Optimization: The act of naming your emotions has been found to benefit wellbeing. Let yourself experience the range of all that you’re feeling and share it with your partner. That said, wise relators allow for “emotional blend,” but have also learned to lean towards or focus on their positive emotions. These are difficult times and also times to deeply feel one’s gratitude for what one has, and perhaps even for who one is. Emotional Generosity: Kindness, patience, humility, and deep regard for the other are all aspects of emotional generosity that you can bring to your relationship. Find that olive branch if there’s a disagreement, and extend it. When asked what they thought was required for a good long-term relationship, these wise elder clinicians said one word more than any other: tolerance. During the COVID-19 crisis, when we can all get underneath each other’s skins a bit too often, remember that word. Tolerance. And while you’re at it, remember why you fell in love with that person in the next room or in the room with you, and reconnect with those feelings.

As the coronavirus robs us of the life we cherish, a renowned therapist, Esther Perel has some advice. Anxiety, dread, depression — these are just some of the emotions that hit us as we shelter in place and as death tolls rise. The irony of the moment, is that in a time of unimaginable death we can be reminded how to live. Social distance doesn’t preclude our coming together. Ms. Perel counsels us to create moments of connection - whether by volunteering, picking up the phone or sharing a story that made you laugh. It is important, she says, to keep living - particularly in moments of grief.