The Process of Change in Therapy

 By Michaela Choy, AMFT

By Michaela Choy, AMFT

As a therapist, I am in the business of change. Change takes many forms depending on who is pursuing this change. Clients bring a whole host of variables to the equation of change including learned behaviors and viewpoints from families of origin, unique belief systems, and significant life experiences. This list goes on. Whatever you bring to the table, will shape your path. Part of my work is to meet you where you’re at and use your strengths to promote change.

Often I’m asked how long the therapy process will take or what the roadmap of change looks like. I’ve found it helpful to discuss a few things (below) with my clients to set realistic expectations for them AND to expand their definition of change so they get the most out of this work.

It’s Messy

The preferred method of change is a map with check points and linear movement – once you’ve completed one task, it’s on to the next. You know you’ve made progress and know exactly where you’re headed next. And that’s very comforting. Change can happen like this, but in my experience, change tends to look much different. It’s messy. It’s not linear. When my clients experience new ways of being, responses and realizations are activated and new paths in the work are uncovered. Responding to what becomes activated for you makes the work rich and thorough, and this will help promote lasting change. Your responses are happening for a reason, and it’s best to honor them versus bulldozing past them. If not given the time and attention they need, they will pop up again.

It’s Gradual

One of my teachers explained the impact of small change over time. He used the metaphor of a boat changing its course by several degrees. At first it may not seem like much is happening, but over the long run, your boat’s course will look much different than its initial course. Even a small 2-degree change has big impact over time. Develop respect for this process. You may want faster results, we all do. But change is in fact happening.

The 80/20 Rule

Your commitment to the work is key. It’s going to be hard. If it wasn’t, you wouldn’t be here. It takes persistence, curiosity, and effort outside of therapy. Many wonderful moments and realizations happen in therapy, and it’s the client’s responsibility to reflect on this work and experiment with these ideas outside of therapy. 80% of the work happens outside of the therapy room. 20% happens in the room.

5 Grounding Exercises for When Anxiety Hits

By Caitlin Nelson, LMFT

Anxiety is often not a favorite feeling. It can make us feel panicky, tense and not in control. While helpful in small amounts, anxiety can feel overwhelming when it is more intense. Grounding techniques are helpful in-the-moment exercises to decrease those feelings of anxiety and bring us back to the present. Here are five quick grounding exercises to try when you’re feeling anxious:

1. The “54321” Technique

- Name 5 things you can see right now (tree, bookcase, etc)

- Name 4 things you can feel right now (feet on floor, back on couch, etc)

- Name 3 things you can hear right now (music, people talking outside, etc)

- Name 2 things you can smell right now (fresh air, food cooking, etc)

- Name 1 good thing about yourself (I am thoughtful, I am strong, etc)

2. The Category Game

Try to name as many different items in a category that you can remember, such as different types of dog breeds, movies you’ve seen, cities you’ve visited, types of food, etc.

3. Square Breathing

- Inhale for 4 seconds

- Hold for 4 seconds

- Exhale for 4 seconds

- Hold for 4 seconds

- Repeat

Focus on how your breath feels coming in and out of your body during this exercise, and make sure to breathe from your diaphragm so that your belly expands before your chest.

4. Repeat a mantra or soothing statement to yourself

- “I can handle this”

- “This feeling will pass”

- “I am safe right now”

5. Remind yourself of things you are looking forward to in the next week

- Trying a new restaurant

- Going to a movie

- Spending time with a friend

Braving the Wilderness: A Mini Review

By Sasha Taskier, AMFT

I recently read Braving the Wilderness, Dr. Brené Brown’s newest book on the quest for true belonging in an era of emotional disconnection and political toxicity. I have long been a fan of Dr. Brown’s work; I try to reread her books Daring Greatly and Rising Strong every chance I get, and I am constantly recommending them to both clients and friends alike. I had very high hopes for her newest work, and let me tell you, it surpassed even my incredibly high expectations.

Here is a mini-review of the book, including reasons for its potency and relevance, and some of my favorite takeaways.

Brown explores to the rise of disconnection in our communities. She sees that our political parties have become gangs that leave no room for dissent amongst us. Perhaps more importantly, if we stay inside these bunkers, we lose the ability to connect with those on the outside. We are the most separated and siloed we have ever been, and despite being surrounded by the people who (likely) share our political beliefs, we are also the most lonely, isolated and disconnected we have ever been. So, while we may be gathered under the same bunkers of political ideology, we are really still alone.

Rather than continuing to stay in our bunkers and stonewalling (or fighting) with anyone who has a different belief than ours, Brown encourages us to learn to stand in the wilderness and begin to have the hard and painful conversations. Only through these moments of real connection can we better belong to ourselves and to one another.

To do this with any sort of success, Brown provides practices and tools that are meant to help us step into and become, what she calls “the wilderness”, both rooted deeply in our beliefs and integrity, and courageous enough to open ourselves to those around us even if we know it might not be popular opinion. We must choose courage over comfort and learn to embrace vulnerability. Both vulnerability and joy are the keys to true belonging.

Here are her tips for braving the wilderness:

  • Boundaries: Set/Hold/Respect them. The challenge is letting go of being liked and the fear of disappointing.
  • Reliability: Do not over commit or overpromise to please others or prove yourself.  Say what you mean and mean what you say.
  • Accountability: Issue meaningful apologies. Let go of blame and stay out of shame.
  • Vault: Share only what is yours to share. Stop using gossip to hotwire a quick connection with someone.
  • Integrity: Choose courage over comfort. Practice living in your values.
  • Generosity: Be honest and clear with others about what is ok and what is not.

Brown masterfully provides both research findings and anecdotes to better explain and unpack how these tools show up in our daily lives and why they are so integral to true belonging. One of my favorite sections from the book was a practice called: Hold Hands with Strangers.

She teaches that collective joy and pain are the cornerstones of human connection; “seek out moments of collective joy and show up for collective pain.” These are the moments that reinforce our human connection, such as concerts, sporting events and even movies where there is a palpable force of love and connection in the audience. Have you ever felt an experience of collective joy? For me, singing songs arm in arm with my best friends at my childhood summer camp triggers those memories. Even the joy I experienced at a Beyoncé concert, singing and dancing with strangers who loved her the same way I do. They were moments that, although maybe silly, made me feel hopeful about the goodness of people.

Moments of collective pain, such as funerals, or sitting with a friend who is grieving or hurting, are profoundly important - albeit much more difficult and uncomfortable. We need both.

Brown shares a study that examined the impact of collective assembly. The findings showed that these experiences “contribute to a life filled with sense of meaning, increased positive affect, increased sense of social connection, and decreased sense of loneliness. All essential components of a happy healthy life.” The best part is, they have a lingering effect; we hold onto these positive feelings past the events themselves.

Even since the rise of social media in the last decade, we have become simultaneously more connected and more isolated and lonely. Brown’s ultimate message resonates with me very deeply - if we want true, authentic belonging in this world, we first have to know who we are, what roots us and only then, can we turn outwards and engage with our friends and communities from a place of curiosity, vulnerability and shared humanity.

There are countless pieces of wisdom in this book, from conflict transformation tools to parenting advice, and its message could not be more important or relevant for our world today. So, pick up a copy - (and then talk to someone about it, in person!)

The Power of Positivity

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By Caitlin Nelson, AMFT

Prioritizing positivity about ourselves has taken a bit of beating over the years, in part due to the rise of social media. We are invited to compare ourselves, almost constantly, to the rose-colored images of other people’s lives. The impact this is having on our well-being has been tied to an increase in anxiety and depressive symptoms. Our ability to remind ourselves that social media is a highlight reel, rather than a true depiction of others, allows us to stay mindful of reality. It also allows us to cultivate an appreciation for the positive aspects of our own lives.

Feeling grateful increases our sense of satisfaction and our self-esteem. It can also decrease the felt impact from negative experiences. An easy way to begin focusing on the positives in your own life is to keep a gratitude journal. Gratitude journals have been shown to decrease stress, improve sleep, and increase self-awareness. Dedicate time throughout your week to document what you are grateful for and allow your positive sense of self to flourish.

Learn more about the impact of social comparison here.

Delve further into gratitude journals here.

A Case to be (a little more) Selfish

 By Sasha Taskier, AFMT

By Sasha Taskier, AFMT

The word selfish has such a negative connotation. From a young age, we are taught not to be ‘selfish’ – we are taught to share, to be generous, to even sometimes put others’ needs before our own. While all of these lessons remain important, and are a part of the recipe for harmonious and reciprocal relationships, I have to ask: have we taken it too far? Have we gotten stuck in a cycle of putting everyone and everything before ourselves?

Recently, I’ve been hearing more and more from clients, family, and friends just how exhausted they are. Exhausted by their work, by their social calendars, and by the expectations they’ve put upon themselves to be stellar employees, parents, friends, and partners. We’ve put an immense amount of pressure on ourselves to show up in these roles, and while I absolutely believe these efforts are meaningful and worthwhile, how long before we are trying to pour from an empty cup?

When I suggest to my clients that perhaps they need to focus a bit more on themselves, it is often met with resistance; “but, I have no time” or, “I know it’s bad, but this is just a difficult time of year” or, “I honestly have no idea what that would even look like.” I would be lying if I said I couldn’t identify with every one of those excuses, because they are true! We do have a litany of obligations; we do have friends and family depending on us; we do have impossible work schedules that make the idea of a regular exercise routine seemingly comical. And yet, I wonder, how far are we willing to push ourselves? And, more importantly, to what cost?

How can we be the stellar employees, friends, parents and partners we strive to be if we are running on fumes? How on earth can we respond to each other with compassion and patience when our reserves are diminished? I like to think about an electrical outlet – envision the many things plugging into you for energy: your families, your job, your home, even, maybe your pet… but what do you plug into? What is your energy source (and how often are you using it)?

Organizational psychologist and author of Grounded: How Leaders Stay Rooted in an Uncertain World, Bob Rosen states: “When you take care of yourself first, you show up as a healthy, grounded person in life…If you can’t take care of yourself, then you can’t care for others. Being selfish is critical.” So, while perhaps an unpopular perspective – maybe we can encourage ourselves to be a little more selfish, not only as a necessity for our own well-being, but also as a service to those we love most.

Here are a few ideas and exercises to think about on this topic:

  • Write down 20 things that you love to do. No specific order, no right or wrong answers, just jot down 20 things that make you happy. (For example, reading a novel, taking a yoga class, traveling internationally, having dinner with friends, exploring new neighborhoods, walking the dog, etc.) Then, write next to each item, when the last time you actually did that activity (days/weeks/months/years). It can be a glaring exercise to realize that we haven’t engaged in activities that bring us joy in months or even years. [Activity adapted from The Artist’s Way, by Julia Cameron]                                                                                                                                                                                                                       
  • What can you say ‘NO’ to this week, (or this month)? Sometimes things that are supposed to bring us joy – like seeing friends, or going out for dinners etc., bring us more stress than we realize. We are so accustomed to saying ‘yes!’ to invitations and expectations, but what if we chose just one thing and said no rather than yes. Barricade yourself at home for the evening, (or in a happy, relaxing place) and play hooky.                                                                                                               
  • Engage in service. This might seem counterintuitive – but if you have ever spent time sitting with someone who is ill, or serving food in a soup kitchen, or volunteering at an animal shelter, you know – there are few things more energizing than giving back to those who truly need your help. Not only is giving back good for our communities, but it is good for our spirit. You can search for volunteer opportunities at chicagocares.org.                                                                                                                                                                                                                                                     
  • Take 10 minutes for yourself. Whether it is walking to get yourself a coffee in the middle of the work day, or setting your alarm a bit earlier to sit quietly or stretch first thing – this tiny exercise in slowing down, can help us towards a more mindful reset.                                                                 
  • Plan something indulgent. While we can’t necessarily treat ourselves to a getaway or a massage every day, or even every month – there is research that suggests that the ‘build up’ and excitement for planning a trip is even more enjoyable than the trip itself. So, maybe begin to plan that trip you’ve wanted to take; savor the entire process. [Source]