"The fourth trimester, or the first months after a baby's birth, is critical for mom and her obstetric care team. In this episode, we'll discuss why a postpartum checkup is so important - from physical recovery after giving birth to the signs and symptoms of postpartum depression."
By: Richard Brouillette, LCSW | August 1, 2022
"This is part two of a two-part post. Click here to read part one."
"When we focus on possible outcomes and scenarios based on anxious thinking, our brain does what Ethan Kross, in his new book Chatter: The Voice in Our Head, Why It Matters, and How to Harness It, describes as “projecting scenes onto our mental home theater” as images in our mind’s eye. A fascinating element of mental home theater imagery is that we can experience events in our mind from different perspectives. This led Kross and colleagues to conduct an experiment that asked participants to imagine an upsetting memory— except some participants were asked to imagine reexperiencing the memory first-person, while others were asked to experience the memory as though they were watching events happen from a third-person, outsider perspective. Kross called the two groups the immersers and the distancers. The striking result was that the distancers coped much better; they were able to empathize with others more, have more sympathy for themselves, and understand when they were being irrational. It turns out that viewing our troubles through a third-person perspective also has the benefit of reducing the effects of being stuck in a survival-mode, fight-flight-freeze stress response. This also means less physical stress when imagining tough scenarios and problem-solving.
Kross calls this a “distancing approach.” He goes on to explore types of distancing, including journaling about your life from the perspective of a neutral observer, and “temporal distancing,” in which you imagine yourself in the future, after you have come out of the stressful time you currently experience.
All of these techniques show that when you distance, you are able to be less emotionally triggered, less stressed mentally and physically, and you make better judgments and decisions.
To a schema therapist, Kross makes stunning points regarding distancing and talking out loud to yourself, or speaking to yourself by name. In neuroscience-speak, talking to yourself “triggers the pattern recognition software” we use when talking to someone else. This is a verbal kind of distancing, or distanced self-talk, yielding very quickly the same benefits of distancing that come from scene imagery and journaling. This means talking to yourself in the third person, calling yourself by your name. An example Kross offers is when, during a night of insomnia and anxious mental chatter, he says out loud to himself, “Ethan. Go to bed.”
Another, very moving example of distanced self-talk came out of University of Buffalo experiments with children doing distanced self-talk as a way of coping with losing a parent. Children who talked about experiences using the “I” pronoun were more likely to develop symptoms of PTSD. But those who practiced distanced self-talk coped better. Self-talk, again, is addressing the self in the third person: “No matter what, their dad loved them, and they have to think of the good things that happened… they can hold on to the good memories and let the bad ones go.”
Schema Therapy and Four Distancing Tools
For decades, schema therapy has been developing, honing, and practicing distancing tools very much in line with Kross's neuroscience research. The next time you find yourself caught up in anxious chatter, you may have some success trying one of these techniques. These exercises may be most effective if you try journaling about your experience as you practice them.
Imagery Rescripting. Work with a scene in the video library of your mind, whether it’s a memory or an imagined scene you’re worrying about. Start with the scene as you see it. Next, switch your perspective to being a spectator watching the scene happen to you. Speak about yourself in the third person: “What does she need right now to get through this?” Your answers, for example, could be “strength” or “confidence” or “compassion” or “understanding” or “fairness.” Now reimagine the scene with a different outcome, including the qualities you believe “she” needs. Tell yourself you can imagine having these qualities so that you connect to them.
Parts Dialogue. If you are stuck in a chatter mode that is negative and self-critical, try to separate yourself into parts and have them talk to each other. Try allowing for the voice of your inner critic to speak, and then respond from the perspective of a realistic, skeptical, self-compassionate you. When both voices talk, they should speak about you in the third person. Inner critic: “He should have known better; this never would have happened.” Compassionate self: “It’s not fair to expect anyone to predict the future that way! Sometimes bad things happen in life, and being critical like that isn’t going to help him.”"
By: Mark Travers Ph.D. | August 22, 2022
"Relationships are the foundation of life, and the one we have with ourselves is paramount. Unfortunately, many of us take it for granted. Here, I’ll talk about three research-backed ways to calm your inner demons and approach life with a heightened sense of self-compassion.
1. Respect Your Learning Curve
Many of us have unrealistic expectations about how long it takes to acquire new skills or adapt to new environments. We believe that if we enroll in a program, or take a course, our brains will magically open up and absorb all the new information. Of course, the marketing of quick-fix and speed-learning programs is much to blame for our unrealistic expectations. (Sorry, but there’s no such thing as eight-minute abs or four-hour work weeks.)
Cognitive psychologists will tell you that learning is a gradual process and one that cannot be rushed. There has been a lot written about the 10,000-hour rule—the premise being that, on average, it takes about 10,000 hours to master any new skill. While there’s a lively debate over how accurate this rule actually is, the broad takeaway is highly relevant: Learning takes time.
Yet we routinely chastise ourselves for not getting things right on our first, second, or third tries.
When you start thinking this way (and we all do it), you need to remember to be nice to yourself and respect the learning process. If you don’t, you run the risk of disengaging with the learning exercise altogether.
Furthermore, we have to be careful about setting comparison points. What I mean by this is that if we compare how much progress we’ve made from this week to last week, we’re probably going to be let down. Remember, learning is a gradual process. However, if we widen the comparison window—say, from last summer to this summer—we might find a bit more appreciation for the gains we’ve made. Remember Bill Gates’s famous adage, “Most people overestimate what they can do in one year and underestimate what they can do in 10 years.”
On a similar note, it’s important to keep in mind that forgetting is a necessary part of learning. Don’t beat yourself up for forgetting things. If we didn’t forget, our brains would fill up with useless information. Forgetting allows us to synthesize information into usable "models" that reflect how the world works.
2. Show Yourself the Same Kindness You Show Others
Many of us find it easy to express kindness when interacting with others. However, when it comes to ourselves, we are overly critical. We may believe that self-compassion is self-indulgent and lazy, or that it will somehow fundamentally undermine our motivation.
But this is a flawed and counterproductive belief. In fact, research published in Personality and Social Psychology Bulletin, led by psychologist Christine Chwyl of Drexel University, found self-compassion to be something of a "motivational supercharger": Our research echoes what studies have found time and time again—self-compassion not only feels better than harsh self-criticism, but it works better too, helping us rise to life’s inevitable challenges.
So, the next time you experience a setback, try reflecting on it from a place of self-compassion (e.g., “How am I a better person because of this?”) as opposed to a place of self-criticism (e.g., “Why do I fail at everything?”).
Other new research on self-compassion published in Personality and Individual Differences finds that the ability to treat ourselves with kindness not only helps us get through difficult times, but it also helps us savor the good times. According to psychologist and lead author of the study, Benjamin Schellenberg: People who are self-compassionate may have a better ability to be mindful and present during good times and recognize that they deserve to experience positive experiences to their fullest."
By: Cami Ostman M.S. | June 20, 2012
"Anything worth doing is worth doing badly." — G. K. Chesterton
"One of my favorite quotes is from G. K. Chesterton, a Christian philosopher who argued that most of what must be done to make the world go 'round is done by the average Joe who does not do it perfectly — or sometimes even well.
For reasons that may be obvious to those who know me, I love this sentiment. Like many of you, I exited my childhood as a perfectionist, afraid of making mistakes and determined to do everything I undertook as flawlessly as I could. I approached college with a soul-killing effort that left me exhausted, albeit graduating with honors. And in my first marriage, I was guided by religious ideas about gender roles that sucked me (and I daresay my ex-husband) dry after a decade.
It was an unlikely teacher — the marathon — that taught me, once and for all, to dispense with perfectionism. You see, I don't come from a family of athletes. In my family, aunts, uncles, parents, grandparents — all have eschewed regular exercise. Even in my own generation (brothers and cousins), there are very few who played soccer or softball. We just aren't an athletic clan. But in my first year at community college, I took a dance aerobics class and learned that I enjoyed moving my body. For years, I happily kept up a moderate routine of exercise. And then in my mid-thirties, a friend of mine challenged me to train for a marathon.
I took the challenge and quickly discovered that my body was not built for running. I slogged along on my training runs, barely managing the effort it took to build up my miles. Even now, after nearly a decade of marathoning, I'm no faster than I was when I trained for my first 26.2 race.
Unlike in my education, pure will and effort have not made me better at running. I do not run because I'm good at it. I run because of what I get out of it. I get exercise, yes, but I also get time to meditate, a way to challenge myself, a clear, deep breath during stressful times, and a regular reminder that perfection is overrated.
In this life, we sometimes do what we do because we do it well. Other times we partake in an activity or engage in a task because it is worth doing. None of us is perfect at marriage, parenting, work, friendship, or any number of other things we value. Some days, if we are honest, we will admit that we aren't even good at whatever we're doing. Does that mean we close up shop and quit?
I daresay most of us live with the paradox of working toward “excellence” while making do with "good enough." Perfectionism, that pesky drive to meet some pinnacle of an outwardly defined ideal, is a mean task-master. For those it does not drive into flurries of striving, it often paralyzes."
By: Olivia Remes • TEDxUHasselt | May 11, 2017
"Anxiety is one of most prevalent mental health disorders, with 1 out of 14 people around the world being likely affected. Leading up to conditions such as depression, increased risk for suicide, disability and requirement of high health services, very few people who often need treatment actually receive it. In her talk “How to cope with anxiety”, Olivia Remes of the University of Cambridge will share her vision on anxiety and will unravel ways to treat and manage this health disorder. Arguing that treatments such as psychotherapy and medication exist and often result in poor outcome and high rates of relapses, she will emphasise the importance of harnessing strength in ourselves as we modify our problem-coping mechanisms. Olivia will stress that by allowing ourselves to believe that what happens in life is comprehensive, meaningful, and manageable, one can significantly improve their risk of developing anxiety disorders."
By: Robert Taibbi L.C.S.W. | Posted August 7, 2022
"When my kids were teenagers, they went to an Outward Bound course. Though they each did different things—hiking vs. sailing vs. rock climbing—the core activities were the same: High ropes course, run a half marathon, live in the woods by yourself for three days, build a lean-to, practice how to deal with bears or falling overboard. When they came back, they were pumped: Bring it on! Eat my dust!
In other words, their self-confidence had ramped up by 1,000 points. Why? Because they had spent three weeks continually facing near-death experiences.
Self-esteem, self-confidence, and self-image all fall in the same bundle—about feeling good about yourself, feeling more like a winner than a loser. What gets in the way? Generally, a cause and a result: The cause is that you learned to be too self-critical, likely by having critical and unsupportive people around you. You never give yourself a break; even the smallest mistake—the burned biscuits—is another demerit and sign of your incompetence. Your expectations are impossibly high, and everything—even the biscuits—is what you’re overall competence is measured by.
But the result of this ongoing criticism is that you learned to give up on yourself, setting your self-image in concrete. You no longer try anything new because you “know” it will not work out. You give up on your dreams because you “know” you can’t reach them. You’re one of the “losers”; your life becomes small, filled with resignation. You avoid those break-out experiences that can make all the difference.
Time to make that difference and change that story. Like that Outward Bound course, to change your self-image, and increase your self-confidence and self-esteem, you don’t need to start by changing your emotions or attitude but by changing what you do. Here are some tips:
1. Set a challenge.What is it that you most want to change about yourself? It might be something physical—exercising more, drinking less. Or relational—speaking up and telling others what bothers you rather than holding it in.
Pick one thing. The topic ultimately doesn’t matter. What matters is picking something important enough to motivate you into action.
2. Map out baby steps.This is the key. You may be ready to break out, but the danger is that you try and do the make-over: Work out seven days a week, stop drinking altogether, confront your mother or boyfriend or boss. You’re doing all-or-nothing; you’ll burn out, get frustrated, or it will blow up, only adding more fuel to your story of incompetence. Slow and steady wins the race.
3. Focus on the effort, not the outcome.Sometimes your efforts won’t get you the results you want. You get the courage to speak up to your boss about your schedule, and she still doesn’t change it. You work out for two weeks, but nothing seems to have changed. That’s fine. Don’t measure success by what happens next, but by doing it at all.
Ultimately, the goal is not the outcome—whether you achieve what you’re striving for—but the process—taking the risk, stepping outside your comfort zone, doing rather than believing, or despite believing that you can’t. And sometimes, you will achieve what you want. As you accumulate these experiences and become more comfortable with risk-taking, you’ll change the story. You’re no longer the loser; you’re actually courageous, confident, and competent.
4. Stop that critical voice.But that critical voice will always be looking over your shoulder, ready to pounce and let you know that your success was dumb luck, that it wasn’t significant, that it’s only a matter of time before you fall back into your loser status. You can think of your critical voice as a bully constantly beating you up or as hypervigilant guard dogs trying to protect you. Pick one.
If it's a bully, time to push back. Start by paying attention to when that voice kicks up. Good. Now tell it to stop, practice ignoring it, not letting it distract you from moving forward, and better yet, pat yourself on the back for taking the risk and making an effort. And if you think in terms of the guard dogs, be the alpha, let them know that you’re OK, there’s nothing to worry about, that you got this. Realize that critical voice isn’t you."
By: Daniel R. George, Ph.D., M.Sc. | July 7, 2022
"This post is authored by Mariam Shalaby, a 4th-year medical student at Penn State College of Medicine"
"It is a tumultuous time in the U.S.—politically and socially—and many of us in the field of mental health are additionally tasked with the responsibility of caring for the emotional needs of others. This can be taxing, even for someone like myself who is a medical student training in psychiatry. What are practical steps we can take to maintain a productive and caring presence amidst national turmoil?
A day in the life of a mental health trainee
As a fourth-year medical student, I spend a month at a time training in different locations. Recently, I have been training at the local psychiatric hospital, where patients are cared for when their mental illness leads them to be at risk of harm to themselves and/or others, or unable to care for themselves.
Waking up on a recent Wednesday morning, the first thing did was check my phone. Texts from loved ones working through personal problems flooded my screen. I sent a quick reply — “Thinking of you” — before switching apps to scroll through cute cat videos interspersed with passionate 30-second video clips about baby formula shortages and another school shooting. I clicked my phone screen off before taking a deep breath and getting ready for the day.
Driving to the hospital, I noticed the fluffy clouds and the blue sky above me. It was a pretty June day—a peaceful morning. Merging onto the highway, I noticed the car in front of me. Pink paint emblazoned on its trunk exclaimed: “PAWS OFF ABORTION! STOP CONTROLLING WOMEN.” My chest tightened.
I walked into the hospital and sat down for rounds, which is when the team meets with every patient to talk about how they’ve been and discuss their treatment plan. We interviewed eight patients in a row. When I asked one patient what led her to attempt suicide, she looked at me in the eye and said, matter-of-factly, “I was sexually abused by my father as a child, I have struggled with cocaine use for many years, and I am dealing with unresolved grief from the loss of my husband due to overdose.” I gulped, and said, “I’m so sorry to hear that.” Inside, I panicked: What is going on, and how are we going to fix it?
Finally, we finished rounds. I took a break for lunch at the neighborhood Italian bakery and noticed an enormous plywood sign in front of one of the houses across the street: “FROM IRELAND TO PALESTINE, OCCUPATION IS A CRIME” it screamed at me in black spray paint. I took a deep breath and tried to notice the taste of my pizza and the sound of the birds. The time passed too quickly, and soon it was time to return to work.
When I finally arrived home at the end of the day, I felt drained. I had little energy to do anything at all. And it was only four o’clock; I had gotten home early. I resorted to looking at my phone, and found myself once again watching silly videos that left me feeling just as tired as when I got home.
I’m grateful that, like many other professional Americans, my basic needs for food, water, and safety are met. And I’m grateful to serve in a role that helps others find stability in their lives. But these days, a sense of vigilance and worry often consumes me. Many of us wake up daily to an overstimulating digital atmosphere, a turbulent sociopolitical landscape, and an emotionally taxing job. I walked through the day on edge, alert for threat.
While there are practical ways of responding to outside threats to our senses of security and calm, such as participating in activism about causes we care about and doing our best to care for patients, addressing inner sensations of stress in response to those threats isn’t always so clear. Simply telling myself to “calm down” doesn’t work. Trust me, I’ve tried. That said, here are a few things that I have found to be helpful: