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Psychotherapy can help, here’s a story about how…

Psychotherapy can help, here’s a story about how…

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I am a psychologist. Psychologists are people who spend a significant amount of their life studying how people work and why they do what they do* (for me that started at age 19 and has continued for the past 20 years). We practice psychotherapy. Psychotherapy helps empower people to think differently, feel differently, and do things differently while at the same time helping them see that they are a worthy person just as they are. It’s good stuff.

Here’s a little story about psychotherapy, I hope you like it…It takes place on the planet Edo.

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I know of a planet called Edo. On this planet people are born in a machine that looks like a little space ship. You live in your own ship. You can see other people and interact with them but you cannot really see into each other’s ships. Your ship has a lot of buttons and if you push them you can go forward, backward, and stop. When you are little your parents teach you how to use your ship; they teach you basic things like flying, hovering, and ship maintenance. You can learn other skills by going to school, like how to communicate with other ships, how to quantify things, and a lot of other information about the world outside your ship.

You have dreams about flying to the moon in your ship, you see other people do it and think, “I can do it too”. As you grow up you realize there are still a lot of buttons that you don’t understand in your ship. Your parents try to help you but you realize that they are limited too in their understanding of their ship and so their help only goes so far. Sometimes you feel overwhelmed by your ship and using it feels hard. You push buttons and sometimes you go places you don’t want to go and that’s scary so you stop pushing some buttons. But what if you need those buttons to get to the moon?

As you become an adult you find yourself using the same set of buttons over and over again and it feels monotonous. You start to think maybe your ship is no good, or not as good as others. Sometimes, you wish you had a different ship. You can’t see inside anybody else’s ship so you feel like you’re the only one that feels this way.

You find out about this person who studies how to help people understand and use their ships better. She helps people when they feel stuck. She’s called a psychologist**. She spent a long time studying people’s ships, getting as close an inside glimpse as possible, and she thinks that she can help you understand some of those buttons better and create new sequences and move different places.

You’re scared, what if it doesn’t work? What if I go somewhere I don’t want to go? What if I find out that this ship cannot in fact get to the moon?

She seems to understand your fears, she says that you’ll take it one step at a time and asks you where you would like to go with your ship. You tell her and she seems to understand. She says she’d like to try to help you get there and that she’ll need you to tell her what it’s like in your ship for her to be able to help you. You are scared again, because you don’t really talk about what’s inside your ship. She asks about the stuff that feels like it’s not working. You tell her about the buttons that you’ve pushed that have taken you to bad places, the buttons that seem like they should work but that do not, the ones that you’ve only looked at but never even tried, again she seems to understand. She asks you about the stuff that is working and you’re kind of caught off guard because you never really think about what is working. She says she thinks you’ll start by looking at a sequence you’ve been using and change it up just a bit to see where that takes you. You think this is a pretty small step but it’s actually hard to do and so she helps you through it and once you do it you feel better, more confident, more empowered.

She is really interested in your ship and asks you tons of questions. She helps you decide what sequences of buttons you want to try pushing more and which ones you want to push less or not at all. She is patient when you find it hard to stop pushing a button and never judges you. She sits beside you when you push a new sequence and reassures you that it’s normal to fall, “everybody falls,” she says.

She let’s you be angry when buttons feel like they’re stuck and you wish you had another ship, and then gently brings you back to your ship and what you can do in it. You start to move to places you have not gone before. At first you feel like it’s all because of her, but the more steps you make the more you realize it’s you. You start to feel comfortable in your ship, to appreciate your ship, and to take care of your ship and your ship works pretty well. You hit bumps, but you know how to get up when you fall.

You say goodbye to your psychologist. Maybe you’ll come back to see her if you hit a very big bump or want to make a very big leap, but then you’ll be off again, you and your ship, exploring the world together. You’re not sure you really want to go to the moon anymore, but if one day you do you’re pretty sure you will figure out how to get there.


Jodie Richardson is a clinical psychologist in Westmount, Montreal, Quebec, at Connecte Montreal Psychology Group. The team at Connecte loves writing about ways to boost our mental health and bring psychology into our everyday lives. For more helpful tips, check out Connecte’s blogspodcast, follow @connectepsychology on Instagram or like us on Facebook.


For more reading on psychotherapy check out these blog posts:

CBT: WHAT THE &^%#O IS THAT?!

DIALECTICAL BEHAVIOUR THERAPY: LOOKING FOR THE PLAID

THE SKINNY ON ACT

5 THINGS YOU NEED TO KNOW TO MAKE THERAPY WORK FOR YOU

A few references:

Hofmann, S.G., Asnaani, A., Vonk, I.J.J., Sawyer, A.T., and Fang, A. (2012). The Efficacy of Cognitive Behavioural Therapy: A Review of Meta-analyses. Cognitive Therapy Research, 36(5), 427-440.

Chambless, D. L., & Ollendick, T. H. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual review of psychology, 52(1), 685-716.

Tsai, K, C. (2012). Play, Imagination, and Creativity: A Brief Literature Review. Journal of Education and Learning, 1(2), 15-20.

Notes:

* In Québec the current requirement for a psychologist is to have a PhD in psychology. You can read more here.

** We’re using “she” only for purposes of coherency in this story, but please be advised that good psychologists come in every gender.

Special acknowledgement to Dr. Natsumi Sawada for inspiring this story with her creative ideas and for brainstorming the content with me.

Words Matter: Helping Kids Foster a Healthy Relationship with Food and their Bodies One Word at a Time

Words Matter: Helping Kids Foster a Healthy Relationship with Food and their Bodies One Word at a Time

Photo by  Ali Inay  on  Unsplash

Photo by Ali Inay on Unsplash

Imagine this…

Your overweight teen confides in you that he’s getting teased at school about his weight. You have noticed recently that he has been eating more pleasure foods (like chips) while playing video games. You yourself have gained a few pounds, and you’ve decided to go on a little diet. How do you manage this situation? What do you say (or not say) to him?

Helping children foster a positive body image while developing a healthy relationship with food can seem like navigating a minefield. Messages that our bodies aren’t good enough and that our self-worth depends on our looks are everywhere, while at the same time clever marketing is constantly encouraging us to eat high-fat, high-calorie foods. Body dissatisfaction is common among adolescents, and has been shown to predict unhealthy weight-related behaviours that put individuals at risk of weight gain (e.g., binge eating and reduced breakfast consumption) (1). Moreover, our lifestyles are more sedentary than ever before (2), and global childhood overweight and obesity is on the rise (see http://www.who.int/dietphysicalactivity/childhood/en/).

You may feel like you have no power to influence your children in this toxic landscape that overemphasizes being thin while at the same time encourages overeating. Fortunately, there are some things you can do! It turns out that what we, as parents and caregivers, say about food, weight and dieting (even if we’re talking about ourselves or our friends) matters. For example, when we encourage kids to make healthful food choices, and support them in physical activity, they tend to have more positive dietary habits (like eating more fruits and vegetables) and engage in more healthy physical activity (3, 4). At the other extreme, kids who are teased about their weight in early adolescence tend to have poorer emotional well-being (5) and more disordered eating (e.g., binge eating) in late adolescence and young adulthood (6).

So how can we help children develop a healthy relationship with their bodies, while not making them feel like their self-worth is based on the size and shape of their bodies? In general, we want to try to:

  • Ban any form of diet talk and negative body talk from our homes.

  • Encourage healthful eating and physical activity habits.

  • Through our words, try to nurture an identity beyond physical appearance.

Easier said than done, I know. Check out these specific examples below, taken from and inspired by Dianne Neumark-Sztainer’s book, " “I’m like so fat!” Helping your teen make healthy choices about eating and exercise in a weight-obsessed world" (7).

1. Instead of DIET TALK like:
• "I feel so fat; I need to go on a diet."
• "No thanks to dessert; I’m dieting."
• "I’m so proud of my friend Stacey for sticking with her diet."
• "Have you ever thought of going on such-and-such diet? It really worked for your Aunt Carol."

TRY:
• “I’ll pass on dessert today and have an apple instead; I haven’t had enough fruits and vegetables today.”
• “No thanks, I’m full.”
• “Yes, I’d love dessert. Just a small piece please.”
• “This is delicious. I’m really enjoying this meal. But no thanks to seconds.”
• “I’ve discovered a million different ways to eat fruits and vegetables.”
• “I’m not going on any more ‘diets.’ Instead I’m going to focus on some long-term changes in my eating and physical activity patterns that can make me feel better about myself.”

2. Instead of NEGATIVE BODY TALK like:
• “I feel so fat in this dress.” 
• “I’m working out so much and not losing weight; I don’t know if it’s worth it all the time?”

TRY: 
• “My body has undergone some changes lately; I think I’ll try on something else that might fit my body better.” 
• “I can really tell the difference in my strength and stamina since I’ve been working out.”

3. Instead of over-emphasizing your kid’s PHYSICAL APPEARANCE through comments like:
• “You look so pretty today.”
• “Wow you look great in that picture. You’re the handsomest kid in the class.”
• “You’re going to break some hearts when you’re older with that handsome face.”

TRY:
• “I love your laugh; it’s just contagious.”
• “When you smile, your whole face lights up. It’s just beautiful.”
• “You have a great, unique sense of style. I admire the way you wear what looks great on you instead of what everyone else is wearing.”
• “You look so much like Grandpa; when I look at you it brings back so many great memories.”

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For more great tips and information on this topic, check out my colleague Jodie’s blog post, We All Know What It’s Like To Feel Fat. Let’s Try To Change That For Our Next Generation.

Join us…

  • In person! Come check out our workshop for parents and caregivers, Healthy Children: Body and Mind, on March 25th, 2018 from 1:30 - 3pm at the Sylvan Adams YM-YWHA (Montreal) to learn more about how to help kids nurture a healthy relationship with food and their bodies. Email jrichardson@connectepsychology.com for more information.

  • On social media! Follow our campaign on Instagram @connectepsychology.


Lisa Linardatos is a clinical psychologist in Westmount, Montreal, Quebec, at Connecte Montreal Psychology Group. The team at Connecte loves writing about ways to boost our mental health and bring psychology into our everyday lives. For more helpful tips, check out Connecte’s blogspodcast, follow @connectepsychology on Instagram or @ConnecteMTL on Twitter, or like us on Facebook.


NOTES

  • A shorter version of this blogpost was originally posted as a Facebook post here.

  • Learn more about the research discussed in this blogpost here: Project EAT Publications

REFERENCES

  1. Neumark-Sztainer, D., Paxton, S. J., Hannan, P. J., Haines, J., & Story, M. (2006). Does body satisfaction matter? Five-year longitudinal associations between body satisfaction and health behaviors in adolescent females and males. Journal of Adolescent Health, 39(2), 244-251.

  2. Owen, N., Sparling, P. B., Healy, G. N., Dunstan, D. W., & Matthews, C. E. (2010, December). Sedentary behavior: emerging evidence for a new health risk. In Mayo Clinic Proceedings (Vol. 85, No. 12, pp. 1138-1141). Elsevier.

  3. Pearson, N., Biddle, S. J., & Gorely, T. (2009). Family correlates of fruit and vegetable consumption in children and adolescents: a systematic review. Public health nutrition, 12(2), 267-283.

  4. Heitzler, C. D., Martin, S. L., Duke, J., & Huhman, M. (2006). Correlates of physical activity in a national sample of children aged 9–13 years. Preventive medicine, 42(4), 254-260.

  5. Eisenberg, M. E., Neumark-Sztainer, D., Haines, J., & Wall, M. (2006). Weight-teasing and emotional well-being in adolescents: Longitudinal findings from Project EAT. Journal of Adolescent Health, 38(6), 675-683.

  6. Haines, J., Neumark-Sztainer, D., Eisenberg, M. E., & Hannan, P. J. (2006). Weight teasing and disordered eating behaviors in adolescents: longitudinal findings from Project EAT (Eating Among Teens). Pediatrics, 117(2), e209-e215.

  7. Neumark-Sztainer, D. (2005). I'm, like, SO fat!: helping your teen make healthy choices about eating and exercise in a weight-obsessed world. Guilford Press.

Michael Phelps: Breaking records, smashing stereotypes

Michael Phelps: Breaking records, smashing stereotypes

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Have you ever heard someone suggest that ‘Depressed people are lazy, and they just need to toughen up’? Not only can such statements be extremely hurtful, but evidence flies in the face of such thinking.

Case in point: Olympic athlete Michael Phelps’s battle with depressive symptoms and suicidality. One thing that makes his story so compelling is that he is a record-breaking gold medalist whose training undoubtedly requires tremendous focus and dedication, and who most people would certainly not consider to be ‘weak’ or ‘lazy’.

In recent years, he has opened up about his experiences (1, 2). Let’s take a look at what he has shared, and how this might relate to mental health more broadly:

1. He cited social support as an important factor which helped him realize that suicide was not a good solution.  My clinical experience has shown me that people with depression often tend to isolate themselves. Low mood seems to say ‘just stay in bed, cocoon yourself under the warm covers, things will seem quieter and safer there, and you won’t have to struggle to expend energy interacting with people or doing activities.’  Sometimes people feel like they would be burdening others with their problems, or that others won’t understand what they are going through. But the reality is that isolating ourselves from the people who truly care about us can contribute to further worsening our mood, resulting in a vicious cycle where low mood makes us want to isolate ourselves, which in turn can contribute to further lowering of our mood. And ironically, sometimes the periods when our mood is lowest and our inclination to confide or socialize is plummeting can actually be among the most important times to do the opposite and reach out.

2. He reported having been critical or disappointed with himself when he did not beat a certain world record. This suggests that he may have had a focus on outcome goals, where the motivation is tied to the result (e.g. winning a competition), as opposed to process goals where the focus is on the steps involved (e.g. hard work, love of learning) (3). This may have left him feeling like a failure when he did not achieve his desired outcome. Indeed, some research has found that process goals can have certain advantages, including more enjoyment (4). I’ve often heard clients say things like ‘I’ll be happy when I achieve x goal / when I hit x milestone / when x is over’, but as clinical sports psychologist Kristen Keim noted, it is important to take pleasure in the process and in the moment (5).

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3. He reported that his sense of self-worth declined after he retired from swimming. Sports psychologist Dr. Goldman noted that equating identity with sport can lead some athletes to lose their sense of self (5). It can be very risky to put all of your eggs in one basket by linking your sense of self-worth to any one area of life (be it academic performance, romantic relationships, or physical appearance) because of the negative ramifications for mood and/or self-esteem when we don’t perform as well as we would have liked in that area, or when our involvement in that area diminishes. As such, some therapies encourage clients to develop and value multiple domains of life (6).

4. He noted that he had not reflected on his accomplishments along the way. Perhaps it is surprising that someone who has won so many gold medals during his career would not have already reflected on his successes. But many of us can relate to being focused on getting things done; it can feel like we are running on a treadmill that is going so fast that we struggle to keep up and to catch our breath, making it a real challenge to focus on the present moment and to practice mindfulness. See my colleague Natsumi’s blogpost to learn more about mindful awareness and how you can begin to incorporate it (7).

5. He was initially reluctant to get help, and anxious about the idea of change. Some people think – if you’re not doing well, you should jump at the chance to feel better, right? In reality, things often aren’t that simple. In many ways, we are creatures of habit, and we often find comfort in familiarity, even if that familiarity isn’t ideal. The idea of some unknown change can feel risky or scary, and people may wonder if they are capable of change, if that change will be sustainable, or if they will be fundamentally different people when their depressive symptoms have improved. These are all valid questions; make sure to raise them with your therapist if they are of concern to you.

6. Having benefitted from treatment, he went on to raise awareness and develop a foundation aimed at promoting stress management for youth. Although not everyone will have their own foundation, some people are eventually able to make meaning or see the silver lining in their experience, for instance, by noting that their own struggles have improved their ability to empathize with others and to demonstrate self-compassion.

Bottom line: Struggling with depression does not make someone weak or lazy. And the wide variety of people coming forward about their own experiences demonstrates that very accomplished, hard-working and motivated individuals can struggle with mental health problems. Michael Phelps’s experience illustrates this point well, as well as the importance of factors like social support, motivation, self-worth, and mindfulness in mental health.


Simcha Samuel is a clinical psychologist in Westmount, Montreal, Quebec, at Connecte Montreal Psychology Group. The team at Connecte loves writing about ways to boost our mental health and bring psychology into our everyday lives. For more helpful tips, check out Connecte’s blogspodcast, follow @connectepsychology on Instagram or like us on Facebook.


References

  1. http://www.cnn.com/2018/01/19/health/michael-phelps-depression/index.html
  2. https://www.cnn.com/2017/07/03/sport/olympics-michael-phelps-swimming-mental-health/index.html
  3. Qu, Y.., Pomerantz, E. M., & Deng, C. (2016). Mothers’ goals for adolescents in the United States and China: Content and transmission, J Res Adolesc., 26, 126-141.
  4. Wilson, K. & Brookfield, D. (2009). Effect of goal setting on motivation and adherence in a six-week exercise program. International Journal of Sport and Exercise Psychology, 6, 89-100.
  5. https://www.theatlantic.com/health/archive/2016/08/post-olympic-depression/496244/
  6. Fairburn, C. G. (2008). Cognitive Behavior Therapy and Eating Disorders. New York, NY: The Guilford Press. 
  7. https://connectepsychology.com/blog/2016/1/11/3-simple-mindfulness-practices-for-coping-with-difficult-experiences-and-emotions-in-day-to-day-life

Avoid Avoiding and Embrace Living!

Avoid Avoiding and Embrace Living!

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Have you ever had the thought, “I never want to feel this way again.” Maybe you did something that you felt was embarrassing, maybe you experienced something traumatic, maybe you ended a significant relationship and felt broken-hearted. Maybe someone made fun of you and made you feel small. Maybe you had a panic attack and you felt like you were losing control. 

After experiences like these, we understandably want to protect ourselves from the difficult thoughts and feelings that come along with them. Why wouldn’t we? So we change our behaviours, a lot or a little, to get ourselves as far away from these painful thoughts and feeling as possible. Sometimes though in our efforts to avoid feeling this sort of pain again, we end up avoiding some of the good things life has to offer. After all, most of the awesome, magical, fulfilling things that happen in life often entail tolerating difficult thoughts and feelings – like running a marathon, writing a difficult entrance exam, or asking someone out on a date. Moreover, the things that we do to avoid difficult thoughts and feelings are sometimes unhealthy – like drinking too much, sleeping a lot, overeating or under-eating, obsessively reading the news, etc.

Here are some examples:

Beatrice played and loved sports ever since her early days of elementary school. During her first year of high school, her swimming coach commented that if she could just lose her “baby fat”, she’d really have a competitive edge. Although you would not have been able to tell by the look on her face, in that moment, Beatrice felt deep shame. She started dieting as a way to lose weight and feel in control, and in an effort to avoid ever feeling bad about her weight again. Eventually Beatrice developed an eating disorder, and much of her time was spent thinking about food, counting calories, and exercising. She would avoid social events that involved food, as she preferred to have full control of what and when she ate. Also, because she was underweight, she felt more tired and had difficulty concentrating, so school became more difficult and her grades were negatively affected.

Rahim had a panic attack in the middle of a crowd at an outdoor concert. It was the most awful feeling he’d ever had. He felt trapped and like he was going to die. The next time his friends asked if he wanted to go to a concert, he made up an excuse about why he couldn’t go. Similarly, he started to avoid going anywhere where there might be big crowds, like sports games. When he was in a crowded environment, like a house party, he would use alcohol to ease his anxiety. Eventually, he avoided going anywhere far from home in case he had a panic attack, meaning he stopped travelling, which was something he loved to do.

Daniella had been in a long-term relationship for 3 years. She had never opened up to a person and been as vulnerable as she had been in that relationship, which ended a year ago when she found out her then boyfriend had been cheating on her. Daniella understandably never wanted to feel those feelings of hurt and betrayal again. She tried going on dates to meet someone new, but had trouble opening up and connecting with people. Eventually, she decided that dating was pointless and spent most of her free time working.

Beatrice, Rahim, and Daniella all changed their behaviours to avoid feeling emotional pain. In doing so, however, other important aspects of their lives were neglected. Their relationships suffered (or in Daniella’s case, the potential for a romantic relationship), as well as opportunities for growth and positive experiences. Beatrice wasn’t able to fully engage in school, and Rahim was no longer doing something that once brought him joy, travelling.

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Additionally, some of the methods they used to avoid were harmful. In Beatrice’s case, she restricted her food intake so much that she became significantly underweight and her health was negatively affected. To ease the worry about having a panic attack, Rahim became dependent on alcohol to feel okay in these situations. For Daniella, it is less clear. Being devoted to work and working hard is something most of us see as a good thing. In some cases though, positive or healthy behaviours or activities, such as sleeping, exercising, or seeing friends, could also be ways of avoiding. We may procrastinate reading that difficult email by reading the news, or working on that paper by cleaning our apartments. We may also avoid our feelings by getting caught up in our thoughts. For example, instead of accepting that a relationship is over and processing the feelings of loss and sadness, we might obsess over what went wrong and what we could’ve done differently.

So what should we do if we think we’re avoiding painful thoughts and emotions at the expense of other important things?

1. Take some time to get to know your negative thoughts and emotions. The more familiar you are with the negative thoughts and emotions that tend to come up for you, the better you'll be at managing them before they lead to avoidance. To get started on identifying your thoughts and feelings, check out these helpful worksheets.

2. Make it a point in your day-to-day life to notice what you might be doing to avoid. Ask yourself if there are behaviours or activities that are hard for you to give up, and why. For example, is it hard to give up a night of seeing friends because you would miss their company, or because being alone with your thoughts causes anxiety? Is it difficult to give up exercise because you would miss the mood-enhancing benefits, or would missing a day of your work-out make you feel like a bad person and cause significant distress?

3. Once you’ve become familiar with the thoughts and emotions you might be avoiding, and the potentially problematic behaviour you might be engaging in to avoid, take some time to identify your values. What are the things that are important to you? Is it growth, relationships, hard work, or fitness, for example? When we are clear on what our values are, we are better able to move toward them even when it’s hard. 

No dress rehearsal, this is our life.
- Gord Downie -

4. Practice moving towards your values even when you’re experiencing negative thoughts and emotions. To help in this process, break down your “moving toward” behaviour into small, manageable steps, and use strategies to self-soothe and manage difficult emotions, such as mindfulness and deep breathing (or “power” breathing!). For example, if Rahim wanted to start going to places with more crowds because he values new experiences, he could break down this goal into small steps, and maybe start by going to a crowded restaurant, close to home, with a friend. To help him reduce his anxiety in this process, he could use the techniques outlined here, such as the 3-minute breathing space.

5. Be nice to yourself! We are hard-wired to avoid things that make us feel bad. Most of us have those days when we want to hide under the covers instead of facing the world. Instead of judging yourself for avoiding, try approaching these difficulties with curiosity and kindness. This compassionate mindset will be more helpful in moving toward your values when the going gets tough :)


Lisa Linardatos is a clinical psychologist in Westmount, Montreal, Quebec, at Connecte Montreal Psychology Group. The team at Connecte loves writing about ways to boost our mental health and bring psychology into our everyday lives. For more helpful tips, check out Connecte’s blogspodcast, follow @connectepsychology on Instagram or like us on Facebook.


 Moving through emotional pain towards what's most important: One of of my favorite strategies for staying balanced and getting out of my head

Moving through emotional pain towards what's most important: One of of my favorite strategies for staying balanced and getting out of my head


Guest post from Dr. Natsumi Sawada, Registered Psychologist (originally published here).

Dr. Natsumi Sawada is a psychologist in private practice in Vancouver, B.C. Natsumi is passionate about using psychology to help people live meaningful, peaceful, connected, and joyful lives. For more of Natsumi's transformative tips check out her blogFacebook or Instagram


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A central feature of one of my favorite therapies, Acceptance and Commitment Therapy (aka ACT) is the idea that identifying our “values” and moving towards them even when we are experiencing emotional pain is crucial for psychological health and wellbeing.  

What are values? They are the things in life that are most important to us. They are what we want our lives to be about. They are different from goals in that they are not things that we can achieve or complete and they are not future destinations. They are the the things that are most important to us in life and in the now. Examples might be: Helping, creativity, our relationship, emotional closeness, caring for others, kindness, independence. One way to tap into your values is to ask, “Who or what is most important to me?” I will write more on identifying values in an upcoming blog post.  

So why move towards values even when we feel terrible? 

Well, ACT proposes that pain is an inevitable part of being human (or sea slug for that matter). To experience physical and psychological pain in the form of difficult thoughts, emotions, and sensations is to be human. It is not pathological, abnormal, or something to be changed. Our lives cannot be separated from pain. We inevitably experience loss and disappointment; feel sadness, anger, fear, guilt, and shame; experience self doubt and self judgment. We don’t often recognize that everybody suffers especially in the Instagram era when all we see is everybody else’s glowing faces and smiles on our screens while we struggle through the slop. But the idea that everyone is happy is bogus. The truth is, every person feels emotional pain and will feel pain throughout their life. Values are important because moving towards them orients us and give life meaning (and all the positive things that come with it). If we want to create meaning in our lives we cannot wait for the skies to clear because being human can at times be a little like living in Vancouver in November.  

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This sounds grim but it’s actually great news because to be psychologically healthy we need to experience positive AND painful emotions. For one thing, it’s natural to feel painful emotions. Imagine you never felt sad or afraid. I don’t think I need to explain why that would problematic. Painful emotions and thoughts serve important protective functions. We need to experience fear, sadness, and guilt to function in the world and to be human (more on this later). Some people argue we need to embrace this vulnerability that we all share, to connect with and be of service to others. Some research even suggests experiencing too much positive emotion is bad for our health and well being. It can cause us to engage in more risky behavior, impede our performance, and hinder our ability to empathize and take others’ perspectives (something that is crucial for good relationships). Research also suggests pursuing happiness can do more harm than good because the more people pursue happiness the less they seem to experience it. See this article for more. So forget the “don’t worry be happy" stuff. Ideally we have a little of both.  

However understandably, humans don't like to experience pain (and don’t even like to experience the possibility of future pain) so often when we experience it we struggle against it like a fish on a hook and line. We think about it, we worry about it, we dread it, we anticipate it, we question it, we obsess about it, we try to mentally problem solve our way out of it. A large part of the war we fight against our painful mental experiences (such as sadness, anxiety, anger, worries, doubts, obsessions, rumination) often takes place in the form of a why question: Why can't I be happier? Why me? Why am I so weird? Why am I messed up (or insert another insult of your choice here)? Why does life have to be this way? Why is everybody such a [bleep]?  

According to ACT, while this is a totally understandable response to pain, this mental war is problematic because whether you experience a little psychological pain or what seems like a lot, the struggle against it makes things so much worse; It creates pain 2.0 otherwise known as suffering. This is similar to an idea found in Buddhist philosophy, illustrated by the story of the two arrows:  

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“…When touched with a feeling of pain, the ordinary person sorrows, grieves, and laments, beats his breast, becomes distraught. So he feels two pains, physical and mental. Just as if they were to shoot a man with an arrow and, right afterward, were to shoot him with another one, so that he would feel the pains of two arrows…”   

The idea here is that when we experience pain (it could be physical pain as described here or emotional), we often react to it by fighting against it. We feel anxious and we get mad at ourselves for feeling this way, we feel sad and we feel ashamed, we feel depressed and we ruminate on the question “what is wrong with me?” and then ruminate on the answer, “you are deficient.” This causes us to, in effect, shoot ourselves with a second arrow: We add suffering to pain.  

One goal of ACT is to teach us how to reduce this suffering by learning to let go of the automatic habit of shooting the second arrow when we experience pain and instead move towards our values. Rather than getting caught up in the net of pain and suffering, we engage with and move towards what's important to us even when we feel pain. The idea is that we can experience painful mental events such as sadness or anxiety or the thoughts, “I can’t do it” or “I don’t want to” or “I’m a failure”  AND we can go on bike rides, work in the garden, do our work, paint a picture, act in a loving way, meet a friend, and do other things that create meaning and value in our life. The experience of a painful mental event cannot stop us from doing these things. The idea in ACT is that we recognize these thoughts and feelings with mindfulness AND then we move towards what's important to us with pain in hand.  

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Does it sound hard? It can be! The experience of sadness for example can organize our whole being to want to lie in bed, cry, eat cheetos and ice cream, surf the internet mindlessly for hours, and ruminate about what went wrong. Does this mean this is our only option? No. As difficult as it might be we can mindfully recognize our emotions with kindness and then, with the same attitude of love and care, ask ourselves, “Does acting on my urges take me farther from or in the direction of who or what is most important to me?” We can then do our best to take a small step towards what is important. It is not always easy but with a lot of practice we can learn how to do this. We can learn how to respond more flexibly to emotional pain instead of always going with the knee jerk reaction of resisting it, hiding from it, smothering it, and turning it into suffering. Some of the mental skills that can help us learn to do this are mindfulness, self compassion, and distress tolerance. I will talk more about these skills in future blog posts.    

I’m writing this post because I find this idea of moving towards values with pain particularly valuable and I use it a lot in my own life. When I feel despair, sadness, or anxiety, for sometimes what seems to be no reason at all, one of the most helpful things I've learned to do is to mindfully take note of the emotion and accompanying urges that arise in me, remind myself of my values, and encourage myself to take one tiny step in the direction of my values.  

For example, if I feel despair I might notice the urge to listen to sad music, lie in bed and watch Netflix, or ruminate about the things that are not going well for me and what I’ve done wrong. However, while understandable, these behaviors are designed to numb or escape pain and take me further from my values of learning and teaching, caring for others, developing my skills as a psychologist, being an engaged and loving partner, and creative expression. So, I do my best to notice these emotions and urges with kindness, acknowledge how painful they are, and then if all goes according to plan, I take a tiny step in the direction of my values. I repeat TINY. This is crucial because when we feel anxious or down even “small” steps can seem overwhelming. My tiny step might be washing the dishes in the sink, reading a page of a book, going for a walk around the block, or send a half dozen friends a cat meme (someone usually responds). Although it’s important to note that the point of moving towards values is not to get rid of pain, I sometimes find that after I have made a move towards my values, my difficult emotions loom less large or sometimes even pass. And, at the very least I’m sad but at least I’m sad AND I went for a walk and took a step towards health.  

If you want, try this out for yourself. Write down a few of your values and the next time you find yourself caught up in painful thoughts or emotions, see if you might remind yourself of some of your values and ask yourself the question, “Does acting on these mental experiences or thoughts take me closer to or farther away from what is most important to me?” If the answer is farther you might ask, “What tiny step might I take towards my values?” If this seems really difficult get in touch with a counsellor or psychologist for help. 

It's important to note that what feels tiny to me might feel microscopic to you or it might feel huge. Take a step that feels tiny to you. It might be doing five jumping jacks or washing three dishes or it might be reorganizing your house or running a marathon.  Meet yourself where you are at. The main point is to take a tiny step towards your values, notice that you did it, and see what happens next and repeat. Let me know what happens.