Category: Self-improvement

Your loved one is depressed. How to tell them about therapy

 

You’re sitting with your BFF (best friend forever) as she’s depressed, in tears and describing her extremely painful situation(s). You feel so much for her and also feel frozen. You don’t know what to do or say to make her feel better. All you know is you want her pain to end and don’t know how. 

This is an all too common scenario among those with close relationships. For us empaths (“How to know if you’re an empath“), it can be incredibly hard to sit with challenging emotions or a problem that we can’t “fix” (even if we are 1000% certain we know how to fix it).

So, what the heck do you say to someone who has a lot of pain and several problems that need solving? By now you all know that this is a therapist’s blog and I’m going to recommend that you encourage them to seek professional help with a therapist. You also know that your loved one would benefit from therapy (whether or not you’ve gone to therapy yourself). You know that these problems are obviously too big for you and he to carry alone. And perhaps you can feel the toll it’s taken on your relationship or even your own well-being as a loved one.

“So how do I tell my loved ones to get therapy for depression (or any other mental illness), without stigmatizing or offending them?”

I get this question by clients, other friends, family members and and even fellow therapists ALL. THE. TIME.

Below is my list of things to remember and ways to tell a loved one that they’re in need of professional help.

  1. Start with validating their emotions. Validation is a little like stating the obvious – which is why a lot of people skip it, but people who are depressed really need to feel like their voice is heard or struggle is being seen. This is where you can say things like:
    • You are in so much pain right now.
    • I know this is really hard for you.
    • “You went through something really traumatic. It makes sense that you’re in pain.”
    • “I’m so sorry you’re suffering like this.”
  2. Introducing the idea of a therapist.
    • “You deserve to have someone who is unbiased, non-judgmental and in your corner – on your side.”
    • “A therapist doesn’t have all the history you and I do.”
    • “A therapist has a lot more tools and training than I do to help you.”
    • (For my fellow therapists) “Even though I’m a therapist, I can’t be your therapist. I’m your sister/brother/friend/partner/wife/husband. My love is not professional. Ethically, I can’t be your therapist. My advice is biased — all full of love for you.”
    • If they say they’ve tried therapy before and it didn’t work, encourage them to try with another therapist. Not all therapists will be helpful or the right fit. They can definitely shop around until finding “the one” for this situation, in this moment (sometimes different issues require different expertise).
  3. Why it all matters. We all deserve unconditional compassion.
    • “You deserve to heal appropriately.”
    • “You deserve to feel free to express yourself.”
    • “You deserve to be free of your depression.”
    • “You deserve to work through this issue without fear of judgment or that people will get offended.”
    • “You deserve to self-care. You take care of so many other people. You need someone just for you.”
    • “You don’t have to be alone in your suffering. A therapist can help you hold it appropriately.”
  4. How to seek referrals
    • If your loved one has insurance, there is a ‘member services’ phone number on it (most are on the back). Ask for their mental health services department. I recommend talking to a live person to have them email a list of their providers that are close to the home or work (or the city the person wants to seek services in). They can then cross reference that list online by searching the therapist and a website.
    • You can also type in the search engine of your choice, “Therapist in (city)” or by zipcode.
    • psychologytoday.com is an online therapist directory that you can filter by location and insurance.
    • If your loved one is an adult you won’t be able to call a therapist for them. The person seeking services has to make the call and schedule their appointment
  5. Resources and gifts that inspire healing. I have a Resources page with a variety of books on different issues to heal from. I also wrote an article focused on Mental Health Gifts that inspire healing.
  6. What about you? Yes, YOU! As a friend or family member, it can be difficult to hold all this pain and responsibility alone. If you’re finding yourself in a lot of emotional crises with family or friends, it’s critical for you to get your own support too. You might be having a lot of guilt feelings or a high degree of expectation for how you help them. It’s hard sitting with uncertainty and pain. Feelings and core beliefs of helplessness contribute to burnout, stress and your own ideas of what it means to be a true friend/family member. Sort it out with someone who is trained to work with burnout, self-care, and families afflicted by mental illness. Family Connections is a great source of support for loved ones of Borderline Personality Disorder or Emotion Dysregulation in general. I was trained by them and have implemented this support group in Spanish at Harbor UCLA. It made all the difference in loved ones being able to place appropriate boundaries, self-care and understanding for their family members. The National Alliance on Mental Illness (NAMI) is another great resource to anyone who has been impacted by mental illness (individuals and friends/family members). Check out these posts I wrote about convincing ourselves to self-care and basic self-care practices. They were written for parents, but the message applies to anyone shouldering the responsibility of helping in general. Implement the #meforwe or self(care)ish message if it helps.

   

7. Crises. If you feel that your loved one is a danger to themselves or others, I strongly urge you to call 911 or take them to the nearest emergency room. In Los Angeles County you can also call Department of Mental Health’s Access Hotline at (800) 854-7771 where you can speak to a mental health staff member and who can help with sending out the Psychiatric Mobile Response Team (PMRT) to your home to evaluate someone (wait times vary). Lots of police departments also have Mental Health Evaluations Teams that go out and conduct welfare checks to someone’s home and can also evaluate for a psychiatric hospitalization. Check with your local police station about this resource.

Lastly, I’d like to make myself available as a resource. After being trained in various family support models, I appreciate the love, struggle and compassion of family members. Feel free to contact me at info@sofiamendozalcsw.com to schedule a 15 minute consult to determine if you would benefit from therapy and support of your own.

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SMART Intentions

 

Happy New Year! On January 1, most Americans vow to make some sort of New Year Resolution, behavior change, or as I’d love for you all to call them, “SMART Intentions.” As a therapist and someone who believes in recovery and change, I couldn’t be happier about someone making positive changes to their lives. With every new year comes a rise in reflections and a joyous hope for a better year than last. Unfortunately, when studied (even anecdotally when I think of my own resolutions), most New Year Resolutions get abandoned by the end of January. Some say it’s because it takes a full 30 days to create a new habit, while others say that people aren’t making realistic goals for themselves.

As a cognitive behavioral therapist, I’ve implemented the SMART method to goal planning with clients and even myself. The SMART method to starting out your intentions sets up for success, rather than failure. I like the word intention because it is defined as “a mental state that represents a commitment to carrying out an action or actions in the future. Intention involves mental activities such as planning and forethought.”[1] I also like Intention because, in my opinion, it brings in the compassion in language that is very much needed when introducing behavior change.

SMART Intentions

Specific – You want to be very specific about your intention.

  • Example: lose weight

Measurable – Your intention must be measurable with numbers.

  • Example: “I intend to lose 10 lbs.”

Achievable – Your intention must be the right combination of challenging and achievable. Select something that you’re motivated to do and not too extreme.

  • Example: A healthy weight loss is between 7-10% for most people who are considered overweight. For people who set the bar too high, might get discouraged when their goal number is far from reach or the results are not fast enough.

Realistic – Select your intention based on your established resources, environment, support, etc.

  • If your goal is to run outside once a week, and it’s rain season, it’s probably not too realistic. Likewise, if going to gym requires a membership you can’t afford or too far from your home/work, it’s likely not a realistic intention.
  • Realistic example: For this week, I will intend to meet my 9,000 (up from 8,000) step count daily.
  • Realistic example: I will drink 8 glasses of water (instead of juice) by joining the water club at work where I will have access to water at all times.

Time-limited or think “Time-line.” – When will it be achieved by? Start off small and realistic given the above factors.

  • Example: I intend to lose 10 lbs (7% of my weight) by June 2018 (6 months from today). First week of January, I will do this by adding more vegetables to my lunches and dinners.
  • Second week of January, I will do this by increasing my steps to 9,000/day.
  • Third week of January, I will do this by joining the water club and drinking 8 glasses of water (instead of my usual soda).

Fun Fact: When I was taking my first CBT seminar (as a student), I had to create a SMART goal for myself. I said I would workout 3x/week… it was specific and measurable, but definitely not attainable or realistic given my workload and schedule.

Try this with setting one intention for yourself this week. You can also set an intention for your partner, best friends, co-workers, family members and even pets. The possibilities are endless!

I urge you all to be kind to yourselves as you’re embarking on this journey of reflection and self-improvement. And even if you get stuck, or walk in the opposite direction of your intention (which is super normal in most journeys), notice where you and your emotions are at in that moment (mindfulness practice), and dial back to your intention with the compassionate heart that encouraged you to make this change to begin with. Change your SMART intention if you need to, aren’t being challenged enough, or it’s too hard, or not realistic anymore. And lastly, if you’re the Long Beach area and need help in coming up with intentions for yourself and don’t know where to start, give me a call for a free 15 minute consultation at (323) 351-1741 to discuss your situation and schedule a first session for you.

My SMART intention for my website is to post at least 1 blog article per month (or 12 for the year). I will do this by posting draft articles/titles the minute I get an idea. I will spend 2 hours/week researching, writing and editing.

So, what’s your SMART Intention for 2018?

 

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Grieving after an Affair

Janis Abrahms Spring, Ph.D wrote the amazing guide book, “After the Affair” (this is an affiliate link) for couples struggling after an affair. She is able to break down such complex dynamics that occur in a relationship and/or in an individual when an affair occurs. She labels the partner who didn’t cheat as the “hurt partner” and I love that she does so because underneath the anger, frustration, rage and other emotions, at the very core it is hurt that they are experiencing. Spring points out that these partners are not only going through betrayal, but also a sense of loss of self when a partner cheats. In this short article, I want to focus on the marvelous job she did with highlighting the losses that can come up for many hurt partners when there has been infidelity (but seriously, go get the book. I don’t do this topic the justice Dr. Abrahms Spring does). Additionally, I’d also like to point out that partners are  not the only ones who experience grief and pain when there is infidelity, children of partners who engage in adultery might also experience a lot of these losses when they find out about it. I’ll add my ideas about children’s reactions to each identified loss.

The following are 9 losses that Janis Abrahms Spring highlights:

# 1: Loss of Identity. When people first find out that their partner has been unfaithful a typical response is to feel as though they have lost a part of their identity or basic sense of who they are. For example, if a someone believed that we were the sun and the moon to their partner, or completely respected by them, an affair can trigger lots of confusion about who they think their partner is, and consequently, who they are to their partner. “If you are not who I thought you were and who I believed loved and respected me, then who am I to you?”

#2: Loss of Sense of Specialness.  Similarly to #1, a loss of sense of specialness can occur as well. An affair can signify a major discrepancy in what the partner thought they had in a “happy marriage” or union. It can mark a betrayal of sacred vows and “oneness” that are hallmarks in committed relationships. Additionally, for children, an affair can also be interpreted as the parent “not loving us enough” and betraying the whole family, not just the partner.

#3: Loss of Self-Respect for debasing and compromising self for the relationship. In this loss, some people might feel as though they lost self-respect due to comprising their worth by engaging in extreme behavior non-typical to win the offending partner back or keep the relationship from ending. Examples can include, changing their appearance to win their partner back (extreme weight loss, wearing different types of clothing, or excessive exercising to lose weight).

#4: Loss of Self-Respect when denying signs of Infidelity.  After an affair is out in the open, the hurt partner may start having flashbacks about red flags they denied or even knowing that the affair was taking place, but did nothing about it, confront it or turn a blind eye. Someone experiencing this should know that from a trauma perspective, this makes sense since your brain is trying to protect you from experiencing pain, therefore avoidance of a very painful fact can be quite common. For children, they may take on the burden of keeping this “secret” if they know or feel as though they are responsible to “fixing” the problem. Tip: when talking to children about this, always make sure to they hear from the adult that what adults do is never their fault. Adults are responsible for their own actions, even though those actions might not always be right.

#5: Loss of Control over own thoughts and actions. This is a big one for anyone after experiencing betrayal in a relationship. You might be feeling out of control with your thoughts going a mile a minute or experiencing flashbacks of memories or images of the betrayal. Having a partner who has cheated can be very traumatic for many. Therefore, a normal reaction of the body after experiencing a traumatic event is for it to get ready to fight or flee. Because the body might be trying to protect you and getting you ready to “fight or flee” you might be experiencing body aches, insomnia, paranoia about your partner’s whereabouts (or who they are talking to), sadness, muscle tension, feeling physically ill (headaches, stomach aches, pounding heart, hot flashes). Abrahms Spring highlights even having thoughts of revenge or acting in ways that are not typical for you might come up. In children, we see that when they are going through a stressful time, they will act out physically with peers, are highly irritable, and even withdraw from peers.

#6: Loss of sense of Order/Justice. For some, an affair can trigger a sense that there is no order or justice in the world. Lots of “should” thoughts/statements might come up, such as, “I’m a good person. This should not have happened;” “This isn’t  fair;” “I kept my vows. There is no justice in this world;” “Why do bad things happen to good people? I’m a good person.” “How unfair that I will never love or trust again.”

#7: Loss of Religious Faith. Piggy backing from #6, some people might also begin to feel a loss of religious or spiritual faith. Spring recalls some of her clients saying, “If God loves me, how could he do this to me?” It is normal for someone experiencing betrayal to question fairness and justice, especially from a higher power during such a devastating time.

#8: Loss of Connection with Others. Because some people might be struggling with shame, embarrassment, fearing ridicule, or even extreme guilt, they might be withdrawing from close family and friends. Abrahms Spring does a really great job of highlighting what loved one of the couple might be going through when they hear about the affair. She normalizes the loss of connection with others either due to the hurt partner’s isolating themselves while they deal with these losses, or even because sometimes loved ones simply don’t know what to do or how to respond to such a crisis. Although, she also points out that the hurt partner might also be withdrawn from others due to holding this secret in and even protecting their partner who cheated. This point applies to children as well since they too can attempt to protect parents during times of grief. They might also feel disconnected because they are as they are probably not engaging very much with family or friends due to parents staying away from functions.

#9: Loss of sense of Purpose. The last loss she mentions is the loss of sense of purpose. When the grief is most severe, she highlights that some people might spiral into a deep depression where they questions their sense of purpose and finding it hard to live with the pain of the betrayal. If you or someone you feels as though “living feels more painful” it’s a big sign that professional help might be needed.

I strongly urge everyone who is grieving after an affair to pick up the book, “After the Affair.” It’s comprehensive and non-judgmental. It’s completely revolutionized the way I think about affairs and has helped me understand the complicated dynamic that occurs before, during and after infidelity.

As with any type of grief, it’s important that we acknowledge the feelings that come up during difficult times and talk to people who understand what this process is like. Having your emotions validated and normalized can make a world of difference in your healing process.

Resources:

If you feel triggered by this article and are in need of some immediate resources, I urge you to contact:

  • 911 or go to your nearest ER if you feel you a danger to yourself or others
  • 211 – in LA County it’s the social service directory for grief groups, therapy resources, housing, and more. It’s also online, google, “211”
  • LA County Access hotline for a psychiatric evaluation wherever you are located. The ACCESS/HOTLINE Phone number is : 1-800-854-7771. ACCESS operates 24 hours/day, 7 days/week as the entry point for mental health services in Los Angeles County.
  • Email me at info@sofiamendozalcsw.com if you’d like to inquire about an appointment with me in the Long Beach area. I can also help connect you to other therapists if you live elsewhere.
  • If you would like to access your insurance mental health benefits, there should be a Member Phone number on the back of your insurance card. Ask them for their list of approved therapists. They can also email it to you, making it easy to cross reference the list on www.psychologytoday.com where you can check their profiles out.

Thank you for reading. Follow me on Instagram under @mendingrootstherapy to get updates about new articles, quotes and other musings on mental health.

*Disclaimer: I am a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for me to earn fees by linking to Amazon.com. You should also know that I stand by my recommendations as I read or use everything I recommend. The fees earned from Amazon.com go toward purchasing more books and materials used in my practice. 

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Self-Sabotage

A few weeks ago a colleague and I bonded over discussing Rumi, the 13th Century Persian Poet-Scholar. She has been studying Rumi with members of her Persian community and I have been introduced to his writings and poetry through my personal study on Acceptance and Healing. We (and millions of others) were drawn to Rumi’s words and poems because he captures the essence of emotions through several written gems. I call them gems because when I read them, they illuminate an experience in me that perhaps has been hiding under denial, pain, or masked by other emotions. Uncovering pain is also a gem to me because it highlights how much someone cares and how much their values mean to them.

Earlier this week, she lent me the book, “Silent Words” with hundreds of pages of poems and pieces by Rumi. I flipped through a few pages and found the following gem. “Fearfully, I was stealing from my own gold.” In the poem, Rumi is expressing his experience with doubting his wise friend and spiritual instructor, Shams. By doubting and challenging his wisdom, Rumi says, “Fearfully, I was stealing from my own gold.” It’s that cringe-worthy memory that shows up any time you realize, “‘so and so’ told me this would happen. ‘So and so’ was so right about this and I didn’t listen. The doctors told me this would happen, etc, etc.” I’m sure we could come up with hundreds of scenarios that get triggered by this gem. “Fearfully, I was stealing from my own gold.” I swear, the more times I say it and write it out, the more powerful it becomes. To me, this message and gem is about Self-Sabotage and how at times, we create barriers for the life we want to live.

I define Self-Sabotage as engaging in behaviors or thoughts that move us away from our goals, values, happiness, progress and ultimately, well-being. Giving in to negative thoughts and core beliefs also contribute greatly to Self-Sabotage. What’s important to know about giving in to deeply ingrained negative thoughts and core beliefs is that more times often than not, they are wildly inaccurate. We might have adopted a negative self view of ourselves as children or other painful experiences in which we might not have had a complete perspective, control, or facts and we internalize them as an absolute truth. Giving in to those thoughts and core beliefs takes away from our happiness. It’s stealing from our own gold!

Self-Sabotage and “stealing from your own gold” is also behavioral. For me, it entails those times in which I overeat in an unhealthy way. It entails crossing my own boundaries, such as overworking, over-committing, procrastination, or convincing myself that I don’t need exercise or a day off. I think any fellow workaholic can relate to this.

For others it might be not following a medication regimen, skipping out on doctor appointments, not meeting deadlines, or poor work performance. It means doing things that get in the way of self-care, progress or happiness.

The role of self-sabotage in relationships can be significant. It might look like an inability in trusting others (who are safe to trust), engaging in inappropriate, unbalanced or unhealthy relationships, having unhealthy boundaries, or even avoiding connections.

Stealing from your own gold also encompasses suppressing or over acting on emotions in an ineffective way, which can cause problems in your work, school, or home life. This might look like yelling or lashing out in the workplace; threatening others; not asking for help; or having unfair expectations of others — including loved ones co-workers, teachers, or the general public.  Engaging in such behaviors can cause problems for us in reaching our goals. It can impede 1) having a good relationship with our child’s teacher; 2) being evaluated well in our performance evaluations; 3) having a serene home environment.

One of my favorite sources of research and inspiration is this little cataloging website called Pinterest.com. When I did a search for self-sabotage it pulled up an overwhelming selection of quotes and messages. Among the best in describing self-sabotage were:

  • “Don’t stand in your own way.”
  • “Get off your but.”
  • “Self-sabotage is about wanting something so bad and making sure it doesn’t happen.”
  • “She didn’t know who would leave or stay. So she pushed them all away.”
  • “I’m afraid of what I’m doing to myself, but I can’t seem to stop.”
  • “Stop hurting yourself because you are angry at someone else.”
  • “Do not sabotage your new relationship with your old relationship’s poison.”
  • “We accept the love we think we deserve.”

Impressive and overwhelming list of quotes right? I know. They resonate with a feeling of dis-control that’s linked to hurtful experiences, and actions that we engaged in. I know.

So what do we do about self-sabotage? Below is a list of different recommendations and techniques that I have found to be extremely helpful in identifying self-sabotage and chipping away at it. By no means do I think that these are easy tasks. You should know that it can be a painful process in the beginning, especially if hurtful memories or trauma comes up for you. And some days might be better than others for you to be able to turn your cycle in the opposite direction.  However, please don’t underestimate yourself and your capacity for self-kindness and resilience. (*I also want to be clear that I recognize the role of systemic and societal barriers on our psychology and negative thought process. That conversation, however, is a much more complicated topic and post that, well, yes, I will have to write in the future. You have my word.)

Breaking the Cycle of Self-sabotage
  1. Recognize and acknowledge your self-sabotaging thoughts or behavior. This is a pivotal first step in making a change. Identify your behavior that is getting in the way of a goal you have for yourself.
  2. Observe the negative thoughts that are going through your mind. You can write them down if you want. Think about those one-liners that go through your mind as soon as you decide to go in the direction AWAY from your goal. What are you saying to yourself, about yourself, about others, the situation, the future?
  3. Challenge or evaluate these specific, situational thoughts. Think of evidence for and against it. Is there a more positive way in which you can think of this? Are you taking into consideration ALL perspectives? Are you being unfair with yourself? What would you be saying to yourself if you were being kinder? Or better, what would you tell someone close and who you love if they were in your shoes? Is the thought related to a fact? If it is, evaluate how HELPFUL or USEFUL  the this thought or fact is in your life? Just because it might be true, does not mean you have to adopt it and live your life according to it. Write the new, more positive, true and feel-good thoughts on a card, write in on your Notes app, or take a picture of it and look at it repeatedly for daily reminders. Make a pinterest board out of them (I swear, I’m not affiliated or get paid by Pinterest).
  4. Make a commitment to doing one thing, one action that’s in the direction of your goal. Even if it’s small. In fact, the smaller, the better because it’s more likely to be attainable.

These are small, yet meaningful steps that you can take to break the cycle of self-sabotage. If you’re finding yourself having a difficult time following these steps, go ahead and google ‘Cognitive Behavioral Therapy’ (or go to www.academyofct.org), or even on Amazon. There are tons of amazing self-help books on changing thoughts, feelings and behaviors — all related to defeating self-sabotage and negative thinking.

I think it’s only fair that I also share with your some quotes from Pinterest that to me, help with reversing the Cycle of Self-sabotage. Among my favorites are:

  • “Slay your stress monster”
  • “When you let go, we create space for better things to enter your life.”
  • “I will not feel deprived when I bypass junk food, I will feel empowered that I made a healthy choice”
  • “Remember that you are doing the best you can in THIS moment.”
  • “You are worthy, You are worthy of love, happiness and your own forgiveness.”

Feel free to follow me on Instagram @mendingrootstherapy for inspirational quotes and other musings on mental health and wellness.

Lastly, if you would like a free 15 minute consultation to discuss your situation and if you would benefit from individual therapy, feel free to email me at info@sofiamendozalcsw.com.

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