New Group of Categories – Initiated 11/30/2016

Can’t Sleep? Don’t try this!

If you have trouble sleeping, you may not qualify for a diagnosis of insomnia, but the disturbed sleep may still be significant enough to cause fatigue, stress and perhaps lower functioning. Over time, trouble falling asleep, or staying asleep, or waking up multiple times may be indicative of a more serious problem. If the disturbance persists more than six months, it should not be ignored. A diagnosis of anxiety, acute stress, or another mood disorder may be needed–and perhaps a visit to the MD to see if there may be some organic cause of the persistent sleeplessness.

In the meantime, what to do if sleep won’t come until the wee hours of the morning–until almost when it is time to get up? Let me tell you what will work and will not work. First, let’s talk about what NOT to do.

The following “techniques” will NOT work:

  • Trying your hardest to fall asleep
  • Wishing with all your might that you will fall asleep fast
  • Worrying that you are not going to fall asleep
  • Getting impatient, irritated or angry about being still awake
  • Concentrating on falling asleep
  • Praying intensely that you will be able to sleep
  • Worrying that you will be very tired in the morning

All of these fall under the category of ineffective remedies against sleeplessness because of one simple truth: the harder you try to fall asleep, the harder it will be to fall asleep.

The following techniques have a much better chance to work:

  • Give up trying to fall asleep and tell yourself, “I’ll sleep when I can”
  • Stop wishing to fall asleep and say, “I’m okay with not sleeping right now”
  • Do not worry yourself over sleeplessness: accept it as a temporary problem
  • Stay calm, be patient with your body, soothe your spirit
  • Focus your mind on pleasant memories unrelated to sleep
  • Pray for calm, peace, and acceptance
  • Accept that you may be a little tired in the morning, but tell yourself that you’ll be able to handle your day

Go through a few nights of using these techniques (a week or so) and in the meantime, use these other techniques to get some rest:

  • Catch naps of at least 10 minutes (20′ is better) whenever and wherever you can
  • Cut off the caffeine (coffee, tea, energy drinks) by 3pm each day
  • Cut off the alcohol (it is a myth that it will help you sleep better–it won’t)

You may be tempted to take medication, but beware of the numerous side effects that all these narcotics usually have. If you must take something, take melatonin or drink chamomile tea. Also, while narcotics will put you to sleep (usually, not always) they can be addictive and the sleep won’t be as restful as natural sleep.

If nothing works, see a psychotherapist, because you’ll need to start addressing the cause of your poor sleep patterns, instead of just trying to put a patch on the symptoms.

Are you a human being or a human doing?

When I make a mistake, forget something, mess up something or miss an appointment… is it just what I do sometimes, or does it say something about who I am? This is a crucial question whose answer can make a difference between a healthy or a not so healthy opinion of one’s self. Answering the question requires an understanding of the difference between “being” and “doing.” It is the being that determines a person character, true personality and, ultimately, his or her true self. It is the doing that often is out of character and does not accurately reflect the personality or the true self. The problem is, the doing is often confused with the being. Said another way, what a person does is often confused with who that person really is. Think of it this way: mistaking the doing for the being can lead to a misunderstanding of the person in almost every case. Take for example the immoral, cheating, antisocial individual who writes a large check to a charity and then receives a public recognition of generosity. Or, the church-going, honest, and caring individual who drives by a person in need and does not stop to render aid. Both individuals simply do or don’t do something in a specific situation. Their doing, however, can be interpreted by an observer as representative of the individual’s character, personality or true being, without it being the case. When the doing is not sincere or reflective of the true being of a person, it does not stand the test of time, the test of consistency, or both. In the first example, the evil nature of the individual may never become known to the charity that received the donation, but it is certainly going to be known to anyone who interacts with this person on a regular basis because the true being can never stay hidden for very long. In the second example, the good nature of the individual may not be reflected in the failure to stop and help but it would be known to others who see this person being good in many other situations. So, as far as a person’s social image is concerned, the difference between what people occasionally may do and who they truly are is straightforward: time and consistency will always tell the tale.

There is, however, another more significant problem that affects all individuals who do not understand the difference between what they do and who they are. They tend to misinterpret their own occasional or inconsistent actions as being reflective of their true being. In one scenario, they may form an opinion of themselves which is narcissistically positive by focusing on their occasional good deeds and conveniently ignoring their more frequent missteps. In another scenario, they may have an overwhelmingly negative view of themselves by focusing on their occasional (but perceived as too frequent) missteps and ignoring their good nature, sound character or engaging personality. Either positive or negative misinterpretation of a person’s true being is produced by focusing attention on infrequent, occasional, or inconsistent behaviors. Evaluating a person, or one’s self, based on too few observations (or data points) can lead to the wrong conclusion. A good example of this type of evaluation is that of a new couple who has just fallen in love with each other. Both parties, temporarily blinded by love, need, want, passion, lust or a combination thereof, may gather very little “hard data” on the other person and pay an inordinate amount of attention to what the other person does, misunderstanding his or her actions as being consistent, stable over time, and reflecting of the person’s true nature, character and personality. In many cases, thank goodness, this turns out to be true: he or she IS truly wonderful, and not just temporarily doing wonderful things. In some other cases, however, after the honeymoon is over and things settle down, the behaviors that are inconsistent with the person’s true being become rarer, while the behaviors that are reflective of the person’s true being become more frequent and consistent. At this stage, either the couple accept each other’s finally discovered true being, or they break up.

The hard truth in all of this: the opinion that I have of myself and others must be based, to be valid and usable, on time and consistency of behavior. The good news: this opinion can be changed (and indeed should be changed) on the basis of acquiring additional information on the true nature of the self or on that of others. In individuals who suffer from low self-esteem the opinion they have of themselves is often distorted by a negative observational bias: what they “do wrong” matters far more than who they truly are. The perverse reality in this is that, often, what they “do wrong” is based on their own poor observational skills, on a misinterpretation of motive, or a harshness toward the self that is frequently unjustified. They will say negative things to themselves such as, “I am such a failure, I always mess things up, I can’t get anything done, I am so stupid,” at every turn, many times, every day, no matter the circumstances. What they do becomes a definition of who they are which is far from being objective, measured or consistent with their true being. How many otherwise fairly successful, decent, good human being are walking around believing themselves to be otherwise and are therefore fighting depression, anxiety, and pessimism?

To break this cycle of despair, to change one’s opinion to a more balanced view, to truly find out that what we sometimes do is not the same as who we consistently are requires introspection. It is only by taking a look at our actions in context that we can see the many variables that have caused us to behave a certain way: the lady did not stop her car to help the person by the side of the road because she was traveling through a neighborhood that she deemed unsafe, or because she was running late to pick up her son, or a variety of other legitimate reasons. The man who gave to the charity did so to gain the advantage that an image of generosity could provide to him in certain business deals, or to impress a would-be girlfriend, or to soothe guilty feelings caused by a previous misdeed. Ascertaining our true self also requires honesty of intent, whereby we seek objectivity in knowing who we really are so that we can change what we can, accept what we cannot, and have the wisdom to know the difference.

What is true forgiveness?

We evaluate violations of psychological or physical boundaries in terms of the the amount of injustice perceived. Usually, there is a difference between the way we would like to see the violation resolved (e.g., “I’d like to see him admit to his wrongdoing and ask for my forgiveness”) and what we expect to actually happen (e.g., “He’s uncaring and has no remorse. I expect him to hurt me again”).

More serious violations are the hardest to accept and generally produce an inability to forgive in the wounded party. Unforgiveness is a feeling that encompasses a constellation of negative emotions, such as resentment, bitterness, hostility, hatred, anger, and fear. Over time, and as long as the violation remains unresolved or unforgiven, this feeling attacks a person’s well-being and may end up being more harmful to the wounded party than to the offender. Only true forgiveness can make these emotions go away.

The simplest definition of forgiveness is a mindset that recognizes the violation but chooses to no longer hold it against the offender. This mindset may inspire certain behaviors: in the offender, who may be moved to ask for forgiveness; in the wounded party, who may be communicate forgiveness to the offender; in either party, who may be able to talk to each other about the violation and its forgiveness.

Forgiveness is not reconciliation. Whereas forgiveness is a mindset that changes the wounded party’s feelings, reconciliation is the restoration of trust between the two parties. Forgiveness can occur without reconciliation ever taking place.

Researchers distinguish between two types of forgiveness: decisional and emotional. Decisional forgiveness consists of making the decision to change one’s feelings from negative to positive. This decision is made even if the person desires revenge but intentionally chooses to handle the matter in a positive way. Accordingly, decisional forgiveness is not a process: it is a deliberate, conscious, intentional decision to adopt a different mindset. The wounded party may hesitate and even resist making the decision to forgive, for minutes or even for years. When the decision to forgive is made, however, it is final and complete.

Emotional forgiveness may occur at the same time as decisional forgiveness, but generally it does not. The wounded party may forgive decisionally but fail to experience emotional forgiveness. Conversely, the wounded party may try and forgive emotionally without ever making the conscious decision to forgive. Emotional forgiveness is a process that unfolds over time and which generally begins by identifying feelings of unforgiveness and gradually reducing them by replacing them with positive feelings. Emotional forgiveness is not a behavior, inasmuch as it is an intentional replacing of negative unforgiving emotions with positive emotions toward the offender. The most common positive emotions that are involved in this process are understanding, acceptance, empathy, sympathy, compassion, and love.

True forgiveness includes arriving to a point when decisional forgiveness has taken place and the process of emotional forgiveness has been completed.

Forgiveness is at the core of the Christian faith. Jesus’ sacrifice paid the full cost of the injustices against God. God compassionately and lovingly forgives any person who accepts His forgiveness. Jesus tied God’s forgiveness of individual sins to a person’s forgiveness of others (“Forgive our trespasses, as we forgive those who have trespassed against us.”) In others words, God commands us decisional forgiveness, but also highly desires our ability to achieve emotional forgiveness.

The stress of negative self-talk

There is a constant traveling companion who goes with us everywhere we go. Never leaves our side. Never seems to take a break. Anytime we do something, don’t do something, say something, fail to say something, our traveling companion utters a comment, blurts out a remark, passes judgment on what just happened to us. These comments are whispered directly into our brains, are not heard by anyone else, and come through sometimes subtly, sometimes very loud and clear.

To those of us who are lucky to have had a positive development of our self-esteem, this inseparable traveling companion utters encouraging, fair, balanced, and generally positive comments to our words and actions. Able to discern between a genuine mistake, a shortcoming, and a learning opportunity, our traveling companion offers helpful and positive feedback, helps us recover quickly from upsets and disappointments, and helps us deal effectively with traumatic events. Our traveling companion helps us become and remain better, happier people.

To those of us who had a difficult, traumatic childhood, or have had a series of stressful events in our adolescence or adult life, the traveling companion is a constant source of disparaging, unfair, biased, and generally negative comments about our words and actions. Unable to distinguish between our situational and systemic shortcomings, innocent mistakes, and skill deficits, our traveling companion unleashes a barrage of put-downs, decreasing our ability to face life’s challenges, forcing us to take extreme measures to shut it up (alcohol, marijuana, prescription drugs), and does nothing but add to our misery. Our traveling companion can literally undermine, sabotage and bring more ruin to our life.

Interestingly, few of us are aware that the traveling companions exists. The voice we hear in our brains becomes so familiar, so constant, so automatic, that we fail to consciously register its message, fail to really “hear it” except within our subconscious. Even when we become aware of this voice, we often accept it (or endure it) as a given, something we cannot control, something that goes with us naturally, unavoidably, and permanently.

The traveling companion I am talking about is more commonly known by the name of self-talk. Lucky are those whose self-talk is generally positive. For the rest of us, whose self-talk is generally negative, life is a struggle fought with one or both hands tied behind our backs. Stress is our constant companion. Anxiety ambushes us at every opportunity. The world becomes an inherently dangerous place, people are not to be trusted, catastrophe is just around the corner. Often, alcohol (pot or a Xanax or an oxy) helps shut down the negative self-talk, at least for a few hours. Once the effects of the chemical wear out, it’s back, often stronger and louder than before.

What can be done by those unlucky souls who are stuck with negative self-talk as a traveling companion? The three-step approach of cognitive behavioral therapy has been shown to be very effective in treating this condition and eliminating its deleterious effects. The 3-step approach requires the help of a counselor, especially when the intensity, frequency, and impact of the negative self-talk is affecting our ability to function and increasing our distress to the point of self-medication. The 3 steps are:

1. AWARENESS, which begins with the acknowledgment and acceptance of the negative self-talk existence, facilitates our ability to actually and consciously “listen” to it, and permits us to identify the times and situations when we are most likely to hear it. This is the most important step. This is not yet a fix, it is an essential identification of the problem.

2. SKILL, in developing alternative options through which to see the events and situations that are happening to us, whereby the explanation offered by our negative self-talk is only one of the possibilities, and not the only one. When our negative self-talk suggests a catastrophic outcome, we have the skill necessary to work up alternative, more positive outcomes.

2. COGNITIVE RESTRUCTURING, which leads to a transformation of the negative self-talk in either a positive self-talk or, at least, a more neutral and balanced self-talk. This last step requires time and sustained effort, to counter what is perhaps a lifetime of negative self-talk and turn it into a new, habitual, and permanent way of thinking.

How is talking about my problem going to help? 10 reasons why it is better than not talking at all.

1. Talking about issues forces us to put them into words and thus can focus the mind on important details of the problem. This works very well in all circumstances, but especially if you have trouble concentrating your attention or if your thoughts and feelings about the issue feel like they are all jumbled together. Talking about thoughts and feelings helps bring more clarity to the situation and may be of significant help in coming up with possible solutions.

2. Telling the story to someone else, instead of just telling it to yourself over and over (also known as ruminating), helps you sort out what is often a confused mix of thoughts, emotions, opportunities and challenges. In solving a problem, the first step is to lay out as clearly as possible its dimensions, i.e., its scope, frequency and intensity. Talking about it helps you take this first step much more efficiently.

3. Talking about something that is heavy on our mind help release tension. Most people say that they feel better, and think more clearly, after they’ve had a chance to talk about a bothersome issue. Although just talking about the problem isn’t per se a solution, it is that crucial pre-requisite to finding just the right approach to solving it.

4. Talking is often perceived as an unburdening of the mind. The exploratory process that is inherent to putting things into words not only helps a person understand subtle and often unnoticed emotions, but it also helps in discovering alternative ways to manage strong and often uncomfortable feelings.

5. Talking to someone who’s a good, unbiased listener puts the talker in a position to receive someone’s care, compassion and undivided attention. Any problem is usually made much worse if we feel misundesrtood and uncared for. There are times in which keeping things to one’s self (perhaps motivated by a false need for privacy) may be the worst possible choice.

6. Talking opens up the possibility of receiving some useful advice. It is hard to see things clearly and objectively from within (as in, “not seeing the forest because of all the trees”). Moreover, none of us have all the experience and wisdom needed to address a situation in the most effective way, especially when we are stressed, tired, depressed, or anxious. Talking to someone who’s trained to listen and to counsel may not be the easiest thing to do, but it is almost invariably one of the best choices.

7. Talking and exploring the problem with someone else can help develop ideas and look at all possible strategies and solutions. You’ve heard the saying, “there is nothing new under the sun.” This happens to be true of all things human. Chances are, your problem has been successfully solved by many other people with the same challenges and in the same circumstances. Talking about your particular situation may allow you to take advantage of someone else’s experience.

8. Talking to someone relieves feelings of isolation and aloneness. These feelings are often caused by the very special circumstances or characteristics of the problem itself, which can give us the impression that “nobody would understand it.” This feeling can cause a person to isolate, refuse to address the issue, or resort to alcohol or drugs in an ill-advised attempt to get some relief. Talking is a much safer and more effective solution.

9. Talking about a serious issue with a professional makes you feel better very quickly. The very fact that you’ve taken the steps to make the appointment, go to the counselor’s office, and talk about your situation has an immediate beneficial effect. Most people report “feeling much better” after the very first session of counseling.

10. It’s better than medication alone. Major studies have found an effect size (which is a measure of treatment benefit) of up to 0.97 for talk therapy. For antidepressant medication, the average effect size is 0.31.

Theo Pallake at

Top 11 reasons to love yourself

You must love yourself because…

1…you’re the only one you’ve got

You were born, you grew up, you became an adult…and there you are…you!  There’s no escaping the reality of it.  You are the only one in the world who is… you. Your uniqueness, your particular blend of talents, skills, shortcomings, idiosyncrasies, background, and experience is unmatched by anyone else on the planet. Doing something positive with this unique treasure of a life begins by accepting that you are the only one you are and will ever be.

2… it is a prerequisite to loving anyone else

If you are a Christian, and even if you’re not, you may have heard that Jesus said, “Love your neighbor as you love yourself.”  The key word in that sentence is the shortest word, the word “as.”  It means that unless you know how to love yourself, and are capable of loving yourself, you won’t know how to love anyone else, nor will you be able to.

3… it makes you happier

If you’ve ever wondered how some people just seem to be much happier than others with the way life is, and how they seem to manage their problems and adversities so much better, others have wondered the same thing. This has prompted a significant amount of research on happiness and on what makes it happen, what maintains it, and what it takes to have it.  While there are many factors that contribute to happiness, there is one characteristic of happy people that seems to be there across cultures, times and personalities: happy people do not hate themselves. Instead, they are rather fond of who and how they are, and many actually have a healthy love of self that doesn’t make them arrogant or conceited.

4… it adds to your lifespan

Happy, well-adjusted people seem to prefer lifestyles that add to their longevity rather than detract from it.  Perhaps one important explanation is that they cherish their lives, truly enjoy being with themselves, and are able to form lasting and secure bonds with others.  These are all protective factors that may help explain their longer lifespan.

5… it ensures better physical health

Loving yourself means first doing no harm. To the person who respects the fragility of the body, the need to ensure its optimal functioning, and the precious and irreplaceable gift of good health, harming the self is not even an option. This is why love of self generally leads to good decision-making skills on matters of alcohol and drug use, nutrition, exercise, medication, and risky behaviors. Love of self is also an extremely important component in avoiding major depression, in reducing the impact of stress, and in ensuring better mental health.

6… it agrees with those who love you

Sadly, many people who don’t care very much for themselves often argue with those who care about them. It is not unusual to see people suffering because a loved one insists on maintaining a harmful lifestyle, bad habits, and unhealthy behaviors. To accept someone else’s love, to accept that you are lovable enough for someone else to love you is the greatest joy for those who love you…and for you, too!

7… it helps you get over pain and hurt more quickly

A healthy attitude toward your life’s inevitable challenges comes from a good degree of self-confidence, which helps muster your available resources when the time comes.  Knowing that you can handle a crisis because you believe yourself to be strong, capable and good enough to manage it is the key to reducing the impact of the momentary hurts and pains of life.

8… you can’t be anyone else

Much effort and sorrow may go into trying to be someone you’re not. This effort produces very limited results at best, and at worst it can lead to tragicomic choices.  The reason?  It doesn’t fool anyone into believing that you are actually someone else.  Ultimately, everyone still knows that it is just you, trying to be someone you’re not. And how could it be otherwise?  Think about how much more credible and acceptable to everyone is to be just who you are.

9… it is easier than hating yourself

Hate takes a lot of work. I’ve heard it compared to a cancer that eats away at you from the inside. It is probably something very much like that, at the mental and often even at the physical level. Being unable to forgive yourself for your mistakes, being unable to accept your shortcomings, hating your looks, despising your personality…all this takes an enormous amount of emotional and intellectual energy that could be used towards more productive and enjoyable aims.

10… it makes you look better

When unhappy people are portrayed in movies, plays and novels they invariably are made to look unattractive either in obvious or more subtle ways.  Scriptwriters and authors put something in their demeanor, in their eyes, in their voice, in their mannerisms to indicate that we are seeing someone who is in pain. Self-loathing is visible to others: facial muscles are tense, actions are often contrived or insincere, and stress barely lives under the surface.  Contrast this image with that of someone who has a healthy love of self, and you will see someone who is comfortable with just being and who conveys this sense of comfort to everyone else.

11… it makes you more lovable by others

Who doesn’t love being with someone who can laugh, who can cry, who can be genuinely present?  And who doesn’t dread being with someone who’s always gloomy, depressed, unhappy, or self-critical?  The choice is yours to be one or the other.  Certainly, we all know that positiveness begets positiveness, love begets love, and happiness is truly contagious. Won’t you be that person who is so easy to love because you obviously know how to love yourself?

I need to change… right now!

Many clients who come into my office for help with relationship problems or individual issues are seeking a change of some sort, in themselves or in their situation, and they need the change to occur right now. It is not unusual for someone to come in and expect that one session of counseling, i.e. a conversation that will last about 45 minutes, will be sufficient to solve a serious problem, identify the change that is needed and make it happen right there and then. It is also not unusual for some clients to quit counseling after one or two sessions, because, in their perception, there is no change happening or no immediate resolution.

There are some inescapable, well-documented truths about the process of change. Here are six of them that are worth keeping in mind:

1. Change, of the psychological kind, is a process and not a sudden event. Old habits, bad habits, ingrained patterns, repetitive or automatic behaviors, unconscious beliefs or attitudes are notoriously resistant to change. Even with the best intentions and the best help, it takes time for psychological change to occur–certainly more time than one or two hours of counseling.

2. Change becomes necessary after a dysfunctional pattern that is causing distress and loss of functioning has set it for some time, often for many years and in certain cases since childhood. The dysfunction can be very entrenched: it stands to reason that changing it will require more than good intentions or a brief, superficial effort.

3. We are not always ready for change, even when we think we are, and especially not when someone else says that we are. I see clients who come in at the urging of a significant other, a parent or a friend, who by themselves are not yet motivated to identify the changes that are necessary and, more importantly, are not yet motivated to invest the time and effort that is necessary for the process of change to occur.

4. It takes an average of six to eight weeks to begin to see behavioral changes (i.e. for the individual to begin to act differently) from the time the psychological mofification of underlying beliefs and attitudes is well understood and accepted. This is independent of an individual’s motivation and intention, although when these are positive they facilitate change without necessarily speed it up.

5. All meaningful change has a cost associated with it. Included in the total cost is an investment of time, personal effort, and money. This cost may be seen by some as painful and somehow avoidable, however there is ample evidence in repeated, short-lived, and failed efforts to back up the old adage, “no pain, no gain.”

6. To be worth the cost, a change must be permanent. To be permanent, change must reach deep into the individual’s mind and emotions. To reach deep enough, time and efforts are required. To use the time well and make the effort count, hiring a good, experienced guide is very often necessary.

In a nutshell, to expect something worthwhile to change for a zero investment is a losing proposition. To initiate and sustain change and to be willing to pay the price for it, that’s the stuff winners thrive on.

Stressful Patterns: How Your Attachment Style Can Help or Wreck Your Important Relationships

When it comes to relationships, your attachment style can mean the difference between bliss and torment. But what is your attachment style? Where does it come from? How does it work? To understand the concept of attachment, we must go back to the cradle and to the world which the infant first inhabits. It is a world where primary needs (food, shelter, warmth, cleanliness, security, and human contact) reign paramount. Anytime the infant must experience hunger, disconnect, isolation and pain, a little trauma is the result. When those needs are frequently left unattended, a “primal panic” can be the result, depending on the length and severity of the deprivation. Of these primary needs, the need for closeness with other human beings is the most deeply felt by the child’s mind and spirit and it can be, at times, at least as important if not more important than physical needs. It is not unusual for couples in counseling to express their intolerable distress and deep sorrow about their disconnect from their partner. For example, Jennifer says, “I just can’t seem to reach him. That is why I get so mad. I feel so alone all the time. I can’t bear it.” Or Jeff may say, “She doesn’t even seem interested in talking to me anymore, let alone have sex. All she cares about is the kids. I really don’t have a wife.” These are adult manifestations of the same longing, a cry for help in the face of a painful deprivation of emotional needs for closeness and security.

A secure attachment style results from infancy, childhood and adolescence characterized by positive, attentive, and nurturing care. A secure attachment produces individuals who are well-adjusted, who can form and sustain long-term relationships, and who are not easily defeated by any difficulties that may arise between them and significant others. Far from being overly dependent on others, they can give and take from their relationships with balance and fairness, while remaining strong, confident, and truly themselves. In this sense, a relationship that provides secure attachment can become a safe haven, a secure shelter from life’s storms of anxiety and stress. It also provides a secure base from which to explore, change, play, learn, and grow. Amy says, “Whenever my fear that I may lose my job rears up, I don’t just get angry or overwhelmed. I know that I can always can go to him and get a hug. He is there for me. I can count on him.” A partner’s emotional availability and responsiveness is at the core of establishing secure attachments.

When the infant has the misfortune to experience a caregiver who is frequently absent or unavailable, this intermittent pattern of caring and not caring is traumatic, and produces an insecure attachment style. In time, this translates into a message of rejection, devaluation, scarce importance, as if the caregiver were saying, “Your needs do not matter to me, you are not deserving of my attention, and there is only a fragile connection between us.” When children experience this type of caregiving, their reaction follows a predictable pattern. First, there is distress, crying, and emotional pain, which are the only means available to the infant to get attention. In couples, this would have Marie say, “I cry, even poke him, and poke him again. I know I nag him. Anything to get a rise out of him.” When the frantic attempts to get attention fail, the symptoms of separation distress begin to appear: angry protests, dashed hopes, desperate disappointment, negative cycles of demand and distancing. In children, this can result in acting out behaviors, physical violence toward inanimate objects, highly physical “games” in which the anger of feeling neglected can find its expression. In adult relationships, this insecure attachment may produce angry demands for attention, or the starting of trivial arguments as a way of connecting with the other even if only in a negative way. In time, these cycles of angry pursuit and defensive withdrawal become almost infallible predictors of separation and divorce. Evidence-based research by Gottman has shown that the happiest couples know how to ask for what they need from their partner in a softer, more vulnerable way and they can stay emotionally engaged even when the other partner is temporarily unavailable or distressed. On the other hand, the stonewalling that signals a complete lack of emotional response between the partners almost invariably leads to anger, contempt and then to complete withdrawal.

What can be done to remedy this toxic situation? An understanding of attachment theory and the styles exhibited by each partner is the necessary first step. Understanding alone, however, is not sufficient. Explaining, offering advice and problem solving can only go so far in soothing a partner’s emotional needs. A more indirect approach that offers emotional recognition and contact, one that says, “I am here and I get you. I have your back. Do not be afraid,” is much more likely to be effective. I have heard many spouses complain that their partner is very quick to come up with a fix, when all they want is a loving and caring emotional presence.

Within the two basic attachment styles (secure or insecure), attachment theory further identifies three sub-types of insecure attachment: anxious, avoidant, and fearful/avoidant. In the anxious variant of insecure attachment, individuals become anxiously attached and are constantly worried about the relationship. They are flooded with anxiety and alternate between angry demands and the frantic pursuit of reassurance, which often has the effect of driving their partner farther away. In avoidant attachment, individuals learn (as a defense mechanism) to minimize their emotional needs, to numb their emotions and to focus on others matters, such as work or children. With their partner, they seldom acknowledge their needs and generally do not ask for emotional connection, which often produce anxiety and deprivation in the other partner. Lastly, some individuals exhibit a mixed pattern of behavior that combines anxious pursuit and fearful avoidance of closeness. While this can give a very confusing message to their spouses, “I need you desperately—don’t get near me,” it is quite often evidence of severe childhood, adolescence or adult trauma that was experienced in relationships with significant people. Often, these are individuals who were abused or violated by attachment figures and who are now caught in the painful dilemma of seeking comfort from someone whom they also fear as a dreaded source of danger.

In couples counseling, as well as individual counseling, an exploration of each partner’s attachment style can yield surprisingly accurate results and can help explain relationship difficulties, as well as offer a way forward toward healing and emotional fulfillment.

Don’t let a good crisis go to waste!

hangingonWhen adversity strikes and when it lingers on in our lives, it is easy to think that all of it is just a bad experience and that nothing good can possibly come of it. In fairness, there are situations that look just like that: hopelessly bad. Take for example an important relationship that won’t heal on its own, an otherwise bright child who doesn’t seem to follow the right path, a career that is going nowhere, an income that is simply not enough, or a personal problem that does not seem to get any better. All these are crises, mostly crises of growth whose resolution requires deep changes to be identified and implemented.

Nothing can focus attention more than a crisis staring at us in the face, except that… sometimes we are very good at denying, avoiding, numbing and otherwise doing our best to ignore the problem.  We muddle through, hoping and praying for a magic fix.

Not letting one of these crises fester, linger, and possibly get worse requires courage and faith that a better outcome is possible, even if such positive outcome cannot be discerned right now. Not letting a painful crisis go unattended means having the courage and the resolve to take full advantage of the opportunity (yes, opportunity) that the crisis is presenting to us.

How to turn a crisis into a win

We can do turn a hopeless crisis into a growth opportunity (and thus a win) thanks to several tools that are available to us:

  1. The pain and hurt of the crisis can provide a unique motivation toward change, the type of motivation that is just not there when things are going relatively well. Welcoming the hurt as a means to an end is the first tool.
  2. Discerning the emotional and the rational components of the crisis is the second tool. All crises have a rational side (the facts, the figures, the objective reality of what is happening or not happening) and an emotional side (the mixed feelings, the contradictory emotions, the confusing desires, the fears and hopes we might have). Knowing what is rational and what is irrational is a key to good decision-making.
  3. Identifying what IS must come before deciding what SHOULD BE. A good handle of the situation is the third tool. It is only by knowing what is actually happening, and verifying the accuracy of our information, that we can hope to ascertain what we would like to change. This is a step that cannot be bypassed.
  4. A fourth tool is managing our emotions in situations where the crisis is at its peak: during an argument, when trying to communicate our point of view or understand another’s, when resisting the temptation to shoot from the hip or doing more of what doesn’t work, by controlling anger and despair. Sometime the best course of action is doing less, not more, while working on an effective and perhaps difficult solution.
  5. Switching off the autopilot and taking the controls in our hands is the fifth tool. So many of the daily decisions we make are automatic, out of immediate consciousness. This is not necessarily bad, however when applied to a crisis situation the autopilot can take us but to one pre-programmed destination, i.e. to the pain, the emotion, the helplessness that we’ve felt all along.
  6. Working up options for change is the sixth tool. Here we might want to take advantage of any help that may be available to us: family resources, internet information, the advice of trusted and knowledgeable people, our own experience, the power of prayer. All these can help us work up a set of options from which to choose the best possible course of action.

The moment of truth

When the best option finally materializes in front of us, we may not recognize it right away but it is definitely there. Being open to the possibilities, being flexible in considering all alternatives, being aware of our strengths and weaknesses are key factors that permit us to discern the truth. Additionally, we must have a clearer idea of what is RIGHT in the situation, and not just consider what is easiest, least painful, cheapest, or feels good.

This is when a crisis becomes a win, when it is utilized for growth to its fullest potential: when we finally arrive at the solution, the truth, the change that makes all the difference. There is no greater feeling than to feel the personal power that comes from having considered all options and having made the right decision.

Suicidal? Let’s Talk About It

Far from encouraging suicide, psychosocial talk therapy (a.k.a. individual counseling) that focuses on the suicidal thoughts can be a life saver. Findings by a recent study conducted by Johns Hopkins University researchers confirm that there is a 26% lower risk of repeated deliberate suicide attempts and death in individuals who received psychosocial therapy following a suicide attempt. This is true in spite of the well-known fact that deliberate self-harm is a strong predictor of suicide. The aim of this study was to examine whether psychosocial therapy after self-harm was linked to lower risks of repeated self-harm, suicide, and death from suicide.

The study, published in The Lancet Psychiatry, consisted of a matched cohort study of 5,678 individuals who, after deliberate self-harm, received a psychosocial therapy intervention (counseling) at suicide prevention clinics in Denmark during 1992—2010. The outcomes were compared with 17,034 people who did not receive no counseling after deliberate self-harm. The researchers sought evidence of repeated self-harm, death by suicide, and death by any cause and calculated odds ratios for 1, 5, 10, and 20 years of follow-up.

During the 20 year follow-up, 937 (16·5%) recipients of psychosocial therapy attempted suicide again, and 391 (6·9%) died, of which 93 (16%) by suicide. The psychosocial therapy intervention was linked to lower risks of self-harm (as compared to no psychosocial therapy) and death by any cause within a year. Long-term effects indicated that 145 suicide attempts and 153 deaths, including 30 deaths by suicide, were prevented by counseling.

The significance of this study, and the importance of counseling immediately following or to prevent a suicide attempt, cannot be overstated since suicide is among the top 10 cause of death in the United States. Over one million Americans try to take their lives each year, and over 40,000 succeed in their attempt. Over twenty-five percent of these suicide attempts could be prevented by timely, focused psychotherapy.  According to recent youth suicide statistics,

  • Suicide is the SECOND leading cause of death for ages 10-24. (Source: 2010 CDC WISQARS)
  • Suicide is the THIRD leading cause of death for college-age youth and ages 12-18. (Source: 2010 CDC WISQARS)
  • More teenagers and young adults die from suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza, and chronic lung disease, COMBINED.
  • Each day in our nation there are an average of over 5,400 attempts by young people grades 7-12.
  • Four out of Five teens who attempt suicide have given clear warning signs

Among adults, the highest suicide rate is among men over 85 years old: 65 per 100,000 persons. According to the CDC, from 1999 to 2010, the age-adjusted suicide rate for adults aged 35–64 years in the United States increased significantly by 28.4%, from 13.7 per 100,000 population to 17.6 (p<0.001). The suicide rate for men aged 35–64 years increased 27.3%, from 21.5 to 27.3, and the rate for women increased 31.5%, from 6.2 to 8.1. Among men, the greatest increases were among those aged 50–54 years and 55–59 years, (49.4%, from 20.6 to 30.7, and 47.8%, from 20.3 to 30.0, respectively). Among women, suicide rates increased with age, and the largest percentage increase in suicide rate was observed among women aged 60–64 years (59.7%, from 4.4 to 7.0).

Lead researcher, Annette Erlangsen of the Department of Mental Health at Johns Hopkins, pointed out that people that have attempted suicide but failed are at an especially high risk. “We know that people who have attempted suicide are a high-risk population and that we need to help them,” she says. “However, we did not know what would be effective in terms of treatment.” Dr. Erlangsen commented on the findings. “Now we have evidence that psychosocial treatment – which provides support, not medication – is able to prevent suicide in a group at high risk of dying by suicide… Our findings provide a solid basis for recommending that this type of therapy be considered for populations at risk for suicide.”

The Stress of Unbelief and the Courage of Faith

Not believing in anything beyond our finite life can be stressful. However, believing in a higher power and life beyond our earthly existence can also be stressful. How can these two radically opposed worldviews lead to the same outcome of stress? The obvious answer is that being alive and conscious is in itself a source of stress. Beyond the obvious, however, there are more subtle reasons for the stress caused by unbelief and belief alike.

Why not believing can be stressful

A fundamental tenet of unbelief in a higher power and life beyond death is that the purpose of life is life itself. In this view, there is no point in relying on outside help or comfort of a supernatural kind, because there is no entity out there to provide such help or comfort. Thus, the unbeliever believes that instinctive reactions and determined responses to life’s challenges produce either a positive or a negative outcome due to the simple interaction of forces within one’s self and in relationship to other people. In this view, chaos and randomness may reign supreme in helping provide an explanation as to why stressful situations occur.

A sense of powerlessness against fate, circumstances, random events, unpredictability can make the life of the unbeliever very stressful, at times. At other times, a sense of inner power due to the development of intellectual abilities, particularly good choices, clever decisions, and a good measure of luck can help carry the individual through difficult and stressful times and on to successful outcomes.

Successful outcomes can help promote the idea that one is the sole author of one’s destiny as well as the idea that unsuccessful people simply have not made the right decisions or have not developed their skills to the level necessary to achieve success. The most frequently used measures of human success are plainly visible: money, status, homes, cars, jewelry, fame and recognition, influence and power over others. The appeal of these measures of success is so powerful on the human psyche that many believers in a higher power and in life beyond have at times sought to incorporate them into a set of religious beliefs in spite of even the most glaring contradictions. This may help explain why Islam, a set of beliefs centered around peace has at times become synonym with terror and war.

In the Koran, therefore, the only permissible war is one of self-defense. Muslims may not begin hostilities (Koran 2: 190). Warfare is always evil, but sometimes you have to fight in order to avoid the kind of persecution that Mecca inflicted on the Muslims (2: 191; 2: 217) or to preserve decent values (4: 75; 22: 40). The Koran quotes the Torah, the Jewish scriptures, which permits people to retaliate eye for eye, tooth for tooth, but like the Gospels, the Koran suggests that it is meritorious to forgo revenge in a spirit of charity (5: 45). Hostilities must be brought to an end as quickly as possible and must cease the minute the enemy sues for peace (2: 192-3). –Karen Armstrong, Time Magazine

In a different manner, certain Christian leaders have promoted, and many continue to promote, the idea that earthly possessions, success and power can be an integral part of the life of the Christian believer, and that they are indeed to be pursued since the attainment of these measures of success may imply that multiple blessings are being bestowed by God to those who truly believe.  Herein lies a major source of stress for the unbeliever, or for the believer who chooses to focus on earthly achievements: in their absence (when illness, unemployment, poverty, disability, or financial reverses strike one’s life in spite of every best effort) there is no explanation available, nor is there any source of comfort or hope beyond the visible, the immediate and the tangible that may be available within one’s resources.

The courage to believe

In looking at the opposing view, faith in a higher power and in life beyond can also be stressful.  By definition, faith is a set of beliefs that does not rest on logical proof or material evidence. This virtually complete absence of visible proof is probably the reason why our faith can waver, ebb and flow with the circumstances, or even disappear altogether. Faith appears to run counter to how humans experience their life on this earth, i.e. as tangible, visible and immediate. Since faith has none of these attributes, its maintenance in the face of life’s many stressors becomes a matter of courage.

Courage is the presence of something that can transcend fear. Thus, courage is not the absence of fear. If that were the case, any foolhardy behavior could be called an act of courage whereas very often it is simply a product of ignorance, carelessness, disregard of common sense, substance abuse, or plain stupidity. Courage, therefore, appears to presuppose the presence and the awareness of fear in order to truly exist. Ask any combat veteran, any rescuer or any first responder and they will tell you that, in the moment, they were able to set their fear aside, manage it and act courageously in spite of it.

Faith has at least one feature in common with courage. It too presupposes the presence of something else in order to truly exist. That something is the awareness of doubt and the ability to manage it and to set it aside. I believe this may be the reason why faith that is allegedly without doubt and its awareness is often called blind, fanatical and sectarian. In the name of blind faith, acts can be committed that may clearly contradict its tenets, often without insight or awareness, or with intentional, callous disregard for them.

It takes courage to believe in spite of contradictory evidence or the lack of evidence altogether. It takes courage to manage doubt and to continuously recommit one’s existence to a higher power. It takes courage to rely on the help, hope and comfort that seem to come from nowhere at all. It takes courage to read or hear words that were written or spoken long ago, in far away places, and believe in their validity, reliability, and trustworthiness in our life today.

This type of courage is stressful, because faith itself is stressful. Faith without the courage to doubt and the ability to set doubt aside is blind.

A man of courage is also full of faith. –Marcus Tullius Cicero

Does Faith Help Prevent Depression?

There have been numerous reports in the medical press about the beneficial effects of faith-based beliefs as having a positive influence on stress, depression, and other behavioral health conditions, as for example a 90% decrease in the risk of major depression, assessed prospectively, in adults who reported that religion or
spirituality was highly important to them. There is evidence that this beneficial effect is independent of frequency of church attendance, which has not been positively related to depression risk. Brain imaging findings in the adult children of high-risk families conducted at Columbia University have revealed large expanses of cortical thinning across the lateral surface of the right cerebral hemisphere, which are due to the effect of depression on these brain structures.

To determine whether high-risk adults who reported a high importance of religion or spirituality in their lives actually had thicker cortices than those who reported moderate or low importance of religion or spirituality, researchers at Columbia conducted a new study of 103 adults (aged 18-54 years) who were the second- or third-generation offspring of depressed (high familial risk) or nondepressed (low familial risk) individuals. Religious or spiritual importance and church attendance were assessed at 2 time points during 5 years, and cortical thickness was measured on anatomical images of the brain acquired with magnetic resonance imaging at the second time point.

The results of the study show that, in individuals who cited religion or spirituality as important, and did not specify a high frequency of church attendance, thicker cortices were observable in the left and right parietal and occipital regions, the mesial frontal lobe of the right hemisphere, and the cuneus and precuneus in the left hemisphere, independent of familial risk. In addition, researchers report that the effects of faith importance on cortical thickness were significantly stronger in the high-risk than in the low-risk group, particularly along the mesial wall of the left hemisphere, in the same region where they previously reported a significant thinner cortex associated with a familial risk of developing depressive illness.

Although the researchers note that these findings are correlational and therefore do not prove a cause and effect association between importance of spirituality in a person’s life and cortical thickness, it is nevertheless evident that a thicker cortex associated with a high importance of religion or spirituality may have beneficial effects and help prevent the development of depression in individuals at high familial risk for major depression.

“Our findings therefore may identify a neural pathway through which the personal importance of spirituality or religion protects against major depressive disorder in people who are otherwise predisposed to developing it,” the researchers concluded.

“This study points to measurable, beneficial effects of presumably healthy spirituality, especially for individuals with biological predispositions to depression,” Mary Lynn Dell, M.D., told Psychiatric News. She is a professor of clinical psychiatry and pediatrics at Nationwide Children’s Hospital and Ohio State University and has studied spirituality and religion. The study, she continued, “adds to substantial and growing evidence that psychiatrists should support healthy development in that sphere of patients’ lives. Studies such as these may also inform the particular ways and methodologies religious professionals…employ to care for and work with depressed individuals, while at the same time staying true to their particular religious beliefs and traditions.”

The Overwhelming Stress of Paranoia

My spouse and I have been married for several years and we have beautiful children. Beginning some time ago, and following some life events and difficult circumstances that have occurred to us and between us, my spouse has begun suspecting me (and accusing me) of having an affair, trying to hide financial assets, threatening physical harm, wanting to hurt the children, tapping the phone, bugging the house with cameras and listening devices, not loving, planning on leaving for someone else.  I haven’t done any of these things.  I love my spouse with all of my heart, but this is definitely taking a toll on me.  I am now locked out of the house and there is a restraining order preventing me from contacting my spouse or my kids.  I remember that when we first met I noticed a slightly paranoia, which now has gone off the deep end (at least with respect to me, while still being fairly rational and normal with everything else.)  My spouse will not talk to me at all, throws away my letters, deletes my emails and accuses the counselor we were seeing of lying and now won’t go to a counselor either.  What should I do?

paranoiaIt is likely that your spouse may be suffering from a paranoid disorder. This is a condition that tends to get worse over time, since in many cases its underlying cause affects the brain much like a degenerative neurological disorder.

Some people exhibit signs of paranoid thinking at an early age, which may indicate an early psychological trauma. In one typical case, a patient seen for the first time at the age of 16 had a serious head injury when she was 6. She is now 38 and on certain occasion manifests some paranoid symptoms, but is married with three children and has steadily improved throughout her lifetime. It’s a relatively rare but encouraging example of how paranoia can remit almost completely in a supportive and caring environment.

Many patients with serious paranoid disorders eventually divorce their spouses, despite efforts by everyone who cares for them, including their loving spouses, in trying to stop them. The patient’s therapist, minister, friends, relatives and spouse may go to truly extraordinary lengths to try to prove that the paranoid fears are unfounded, but “proof” very rarely has any lasting effect.

Certain medications can help control paranoid thinking, particularly when the person is experiencing schizophrenic or manic symptoms along with being paranoid. In a pure state of paranoid thinking, without any psychotic or manic symptoms, however, medication has been shown to propduce only minimal improvement. Talk therapy is also somewhat unsuccessful, although there may be instances of nearly full recovery.

People who suffer from paranoid thinking don’t give their spouses too many chances to regain trust. It is possible that paranoid patients may let tjheir spouse back into their world again. If they do, it is important to spend as much time together as possible and be completely transparent about one’s activities and whereabouts. The more time spent with paranoid spouses, the less chances they have to imagine what one could be doing behind their back. Also, stress clearly increases paranoid thinking, and when the couple is together there is generally less wondering and therefore less anxiety.

For a while, the healthy spouse may experience singificant stress from all the accusations, and these may even cause significant anger and resentment. But it is useless to argue. Often, what works best is to reassure the spouse of love, and promise to never leave. This may calm the situation, at least temporarily. Also, it is important to call regularly throughout the day. The more of your time given, especially when it is in the form of undivided attention, the fewer symptoms you are likely to occur.

People with a paranoid disorder imagine all sorts of plots designed to do psychological, financial, social or even physical harm to them. Some are dangerous to live with because they are convinced their spouses are planning to kill them. There are documented cases of paranoid patients who have tried to kill their spouses in what they think is “self defense.” Whenever a patient who threatens to kill their spouse, a separation is a must, until there is clear evidence of remission.

If there does not seem to be any danger, the healthy spouse should make every effort to reunite with the spouse. In many case there is a positive response within a few weeks, or at the most, a few months.

It is advisable to make repeated efforts to talk, and when possible, reaffirm love. It is important to always stick to the truth, refusing to go along with any paranoiod fantasies just to try to get along. If the paranoid spouse demands a confession of having done some imaginary transgression, gently state that you would never do anything to inflict intentional hurt. Give regular reassurance that you care and don’t let yourself become so frustrated that you end up saying something that would would contribute to hurt feelings.

‘Tis the Season … for Reflection

I’m finding it hard to believe that Christmas is only a few days away and it’s only two weeks until the end of the year. Where did this year go?
The space between Christmas and the end of the year can be a great time to take a step back and reflect on the ups and downs of the past year, see what lessons there are to be learned, and to create some plans for the coming year.

For those who really want to get their teeth into this, I recommend Jinny Ditzler’s book Your Best Year Yet!, which takes you through the process using ten specific steps. Here are a selection of those steps to get you started…

First, make an extensive list of all you’ve achieved during 2013. Include absolutely everything, big or small. If you do nothing else at the end of the year I strongly recommend you do this. You’ll be surprised at the number of things you have achieved and how good it feels to acknowledge them.

Secondly, consider anything that didn’t go as well as you’d hoped — or things that you’d intended to do but didn’t. What can you learn from this? Can you take this learning forward into 2014 to ensure that you don’t make the same mistakes again?

Thirdly, consider what you want your focus to be in the coming year. What are your priorities? What’s really important to you? What successes do you want to build on? Are there things in your life that you’d like to drop altogether? Is it time to take a risk and make some radical changes? Or perhaps 2014 will be the year when you really step out of your comfort zone and go for the big goal.

Having done that, come up with a list of your Top Ten Goals for 2014. Ditzler suggests that when pondering these goals it can help to consider all the different roles you play in your life (partner, parent, business owner, employee, community member, sports team member, volunteer etc) and link your goals to these roles. Don’t forget to include goals that relate to your role as ‘yourself’ as well … This helps to make sure you get a good balance between work and rest.

Whatever you decide I hope you have a wonderful Christmas and a happy, healthy and peaceful New Year.

Annabel Sutton

ICF Professional Certified Coach
Member International Coach Federation

I hate myself and it stresses me out!

Self-loveOne of the most important loves of our lives is the love of self, in the right measure, and in the proper perspective. Love of self is an important component in child development that helps produce healthy, fully functioning adults. The acquisition of a healthy love of self in the child can be disrupted or even completely blocked by a variety of factors: traumatic events; lack of love, attention and validation by primary caregivers; mental health issues such as depression, anxiety, and attention disorders. Often, children perceive a disconnect between what their mind tells them they should think of themselves and what is generally true (smart, capable, likable) and how they feel inside about themselves (not good enough or even downright unlikable). This dissonance between self-perception and reality can be quite jarring to a child or adolescent’s mind. It often leads to experimenting with artificial means of enhancing self-esteem, or of at least shutting down temporarily the negative feelings about the self: alcohol, marijuana and other “feel good” drugs.

In the right measure, love of the self is not boastful, arrogant or self-centered — this would indicate a narcissistic personality, or in extreme cases even antisocial (chiefly manifested in a near total lack of empathy towards others). In the right measure, love of the self is strong and yet balanced by an understanding and acceptance of certain shortcomings or vulnerabilities that help the individual be fully human. There is a lot of good, some bad and even some ugly in all of us: the realization of this very human mix of characteristics does not preclude love of the self, it simply makes us more emphatic, compassionate and understanding of our and other’s shortcomings.

The proper perspective on self-love comes from positive experiences, but also from the successful survival of negative experiences that occur throughout our lives. For children and adolescents, this can be hard going especially in the absence of supportive parents, mentors and positive adult role models. It is not unusual for fully grown adults to be wrestling almost daily with an incomplete or insufficient love of the self. This usually takes the form of negative self-talk, a merciless beating one’s self up for even minor mistakes, a virtual barrage of negativity toward the self that is self-produced, self-contained and, for this reason, all the more harmful and tragic. Often, one’s self image does not match that which others have of this person; friends and co-workers may think that the individual is actually pretty good or even excellent in many areas; family members may observe, to their dismay, the contradiction between what they think of their loved ones versus what they think of themselves.

What can be done, when love of the self – out of no fault of the individual – was thwarted by an unfortunate set of circumstances in childhood or adolescence? Can it be regained? The answer to this question is an unequivocal YES! Will it be easy? No, it won’t be easy. What will it require?

It will require at least these three steps:

1. Becoming aware and accepting that the problem of self-love is real, it is a problem in the individual’s life, and that it should be the target of corrective action. This is the contemplative stage of change, when the individual at least knows there is a problem, albeit not knowing what to do about it.

2. Begin noticing all the dozen, hundred and thousand ways in which the individual reinforces negative self-esteem through automatic thought processes. When making a mistake, by action or omission, what do I tell myself? What insults do I hurl at myself, in my own mind? How many times a day do I think something negative about myself? A steady diet of negative selkf-talk fed to the brain every day, over weeks and years, can do some real damage to self-esteem.

3. Begin changing the pattern of negative thoughts by switching off the automatic thinking and becoming more intentional about what we tell ourselves, replacing negative thoughts with more positive ones, at least some of the time.

This initial three-step process of change must be consolidated and maintained over time to create lasting change. Often, the old habit of self-beating comes roaring back, like some bad programming routine that runs in the background, automatically. The important thing is not to give up on the idea that change is possible, that the effort is worth doing in exchange for a happier, healthier and better-adjusted life.