The Four Agreements and How They Can Set You Free

I’ve been struggling all day with a terrible case of writer’s block. Most weeks my blog post will simply form in my head based on something that I experienced, read or thought a lot about during the week. This week, however, I sat in front of my computer with nothing. My world felt heavy and uninspiring and the words refused to come. After staring at the blank computer screen for a while, I went and watched The Trial of the Chicago Seven on Netflix (excellent, by the way). After the movie, I still couldn’t think of anything to say, so I started scrolling through Facebook. That’s when I saw a post sharing information from don Miguel Ruiz’s book The Four Agreements: A Practical Guide to Personal Freedom, and I thought, “Wow. I’ve never written about The Four Agreements, and that book is basically my guidebook for living. I’ve got my topic!”

Ruiz opens the book by describing what he calls “the domestication of the human.” He says that little children are completely wild. They do whatever they want and they don’t worry about what anyone thinks of them. Then, society (parents, teachers, etc.) introduces the concept of “no.” Children are told not to do things that come naturally to them, and they are told that they are bad when they do those things, or that they’re good when they do what society wants. They are rewarded with praise or attention when they do what society deems to be “good,” and they are punished when they do something society sees as “bad.” Over time the child internalizes these concepts of good and bad, and the system of beliefs about what is right and wrong becomes the adult person’s agreements with life.

Most people never question these agreements, but many of them are damaging. Ruiz suggests that by adopting four different agreements, the person can obtain personal freedom.

The First agreement is “be impeccable with your word.” Ruiz discusses how most people have an ongoing negative and self-critical internal dialogue. He calls this negative self talk “The Judge.” He says that The Judge is very ready and willing to point out and shame the person for any minor violation against their agreements. For instance, perhaps you have an agreement with life that it’s not OK fail. If you have this agreement, you might avoid trying new things because the risk of failure is just too high. However, we all have to do new things sometimes, and when you inevitably make mistakes, your internal Judge tells you that you are “stupid,” or “a loser.” You internally say things to yourself that you would likely be quite hesitant to say to other people. This internal harshness reinforces your agreement and makes it even more terrifying for you to do new things that might lead to failure.

Clearly this is a damaging process. In order to overcome it, you can adopt the agreement to be impeccable with your word, which means that instead of judging yourself harshly for any infraction, you instead agree to avoid self criticism–you agree not to say things that go against yourself. Over time this new agreement takes over and clears up the old agreement that you had not to ever make mistakes. Can you imagine how much freedom this would bring into your life?

The second agreement is “don’t take anything personally.” The great truth that Ruiz reveals here is that what other people do or say has nothing to do with you. I believe that this is 100% true. Other people’s actions are a product of their own agreements with life, and you have no control over those. If you think about it, when people apologize they say things like “I’m sorry. I was having a bad day.” They admit that it was never about you in the first place. You have no idea what that other person has been taught, the agreements they may have, or what pain they have endured. If they hurt you, it’s as a result of their own agreements with life, not a result of your unworthiness.

Now, it’s important to say here that not taking it personally does not mean that you put up with being mistreated. If someone is treating you badly, know that it’s not about you, and walk away. Think about how much pain this agreement could spare you. If someone behaves hurtfully to you, instead of taking it on, or trying to prove them wrong, you can simply know that it’s not about you at all and move on from it.

The third agreement is “don’t make assumptions.” It is my belief that most of the pain that people endure in life is due to making assumptions about other people’s thoughts, feelings, or motivations. For example, you’re walking down the hallway at work and you wave hello to your coworker, who seems to look at you and then walk away without returning your greeting. Since you don’t know why your coworker apparently ignored you, your mind starts coming up with stories to explain it. Our minds love explanations for things that don’t make sense to us, even if those explanations are not actually true.

Unfortunately, the explanations our minds tend to come up with are worst case scenario, so maybe your mind decides that your coworker is angry with you about something. You don’t know what it is that you’ve done to anger your coworker, but now you’re behaving defensively around that person, which actually results in that person disliking you. However, what you don’t know is that your coworker is near-sighted and didn’t have their glasses with them. It’s not that they were angry with you. They simply couldn’t see you.

Instead of making assumptions about other people’s behaviors, simply remind yourself that you don’t know what their motivations were. Then ask yourself how important it is that you find out. If it’s truly important to you, then go and ask the other person what happened. If it’s not, then drop it completely.

The fourth agreement is “always do your best.” This is probably my favorite one. Ruiz says that in every situation simply do the best that you can. Don’t do any more or any less than your best. The idea of doing more than your best had never occurred to me before, but it’s extremely important because I think that many people are spending their time doing more than their best and burning themselves out. That’s not healthy.

I also love this little tidbit from Ruiz. He says that if you’ve done your best, then when someone criticizes your performance, you have your answer, “I did my best.” It’s so true! And if someone says, “your best isn’t good enough,” please go back to agreement number two, don’t take anything personally. Clearly that person needs to reassess some of their own agreements. Doing your best is always something that you should be proud of.

Remember that your best will vary over time. Your best will be different when you are healthy and when you are sick. It will be different when you are rested and when you are tired. And your best is always going to be different from someone else’s best. That’s OK. If you truly did your best, then give yourself the credit that you deserve.

For more information, please check out don Miguel Ruiz’s book, The Four Agreements: A Practical Guide to Personal Freedom, or any of the Toltec Wisdom books by the Ruizes (don Miguel or his sons), HeatherAsh Amara, or Carlos Castaneda. These writings have changed my life for the better in many ways, and I think that they can do the same for you.

Embracing Struggle

One of my all time favorite movies is The Princess Bride. It’s full of excellent quotes, incredible satire, and wonderful acting. In the past I’ve had a few Princess Bride quoting duels with friends that eventually dissolve into giggling to the point of tears. Recently I followed Cary Elwes (who plays Westley/Dread Pirate Roberts in the movie) on Twitter, and he has been posting some of his best lines from Princess Bride. Yesterdays was, “Life is pain, Highness. Anyone who says differently is selling something.”

After a chuckle where I remembered the scene from the movie where Westley performs this witticism, I started thinking about struggle. Often, it seems that people are living life to minimize struggle and maximize pleasure. Advertising campaigns center around presenting a problem that people might identify with, and then showing how their product can solve it. Overweight? Well, try this pill. Dirty floor? Well, try this cleaning product. Frizzy hair? Buy this hair product and your problem is solved.

When hard times hit, as they definitely have in 2020, people tend to look forward to a time when the struggle ends and life goes back to being easier. When there is illness, people look for cures. When relationships get rocky, people look for ways to smooth them out.

Clearly, avoiding struggle is part of human nature. Often, I hear parents saying that they don’t want to their children to struggle the way that they did, and then they do their utmost to make life as easy as possible for their children.

While I understand the instinct to protect, and to seek ease, I wonder about the wisdom of this philosophy. Having had my share of hard times, I can tell you that struggle has led to the most growth in my life, the most self-reflection, the most fruitful changes.

An abusive marriage and ugly divorce led to my going back to school and becoming a psychotherapist. A terrible illness led to my journey into authorship, blogging and podcasting. A painful breakup led to intense spiritual growth and a desire to invest in learning about music and another language. When the fires of struggle show up, if we can embrace them instead of fight, they can forge us from a raw metal into a weapon of great strength and beauty.

On the other hand, we’ve all encountered people who are the product of too much ease and too little struggle. We joke that they were “born with a silver spoon in their mouths.” These people tend to be arrogant in their own ignorance of what it is to do hard work–what it is to truly struggle. Often they seem to look down on people who don’t have it as easy as they do, and seem to think it’s some kind of moral failing on their part that the world is harder on them. We call these people who haven’t struggled things like “entitled,” “immature,” and “green.”

Deep down we know that people need struggle to become fully-formed human beings, but we still do our best to dodge it at every turn, and to shield our children from it. We look at celebrities and wealthy people, who we imagine live a life of ease (although this is not actually true), and we think how wonderful it would be to live those lives, leading to even more discontent with the struggles of every-day living.

I would like to advocate for a change in attitude. Instead of looking down on people who are struggling and envying those who have a vapid and overly easy existence, I suggest that we embrace struggle as the transformational process that it is. I suggest that instead of thinking, “Aww . . . poor thing. She/He is really struggling right now,” we think “Wow. That person is really in the forge of the fires of struggle. I wonder what the finished product will be.”

It’s OK to be struggling. It’s a part of life. If your kid is having a hard time with distance learning, that’s OK. Working through that struggle, helps your child to learn how to deal with adversity. Most of us are struggling in some way with the pandemic. Perhaps the struggle is isolation, or joblessness, or fear of infection. Maybe it’s all of these together. And, yes, it is hard, but instead of denying or fighting the reality of your circumstances, I suggest that you ask yourself, “What are the lessons that I could learn from this time in my life?”

Now, I’m definitely not advocating for a “Pull yourself up by the bootstraps” mentality. That’s one of my top ten most hated phrases. What are bootstraps, anyway? And how am I supposed to pull myself up with them? No. Instead, treat yourself and others with compassion. Support the people in your life as they support you in return. We need each other, and there is no shame in that.

I’m saying that struggle is not something to hide from or be ashamed of. It is not something to apologize for. Each person’s individual struggle can be like a personal hero’s journey. Every hero starts out naive and untested, and then is strengthened by adversity. Nobody is born heroic.

I think it would be appropriate to end with a quote that was brought to my attention by Brene Brown in her book Daring Greatly. I think it captures this idea of embracing the formative quality of struggle perfectly: “It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes up short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat,” Theodore Roosevelt.

Gaslighting: What it is, and How to Recognize it

It wasn’t until after my first marriage that I first heard about the concept of “gaslighting,” and as soon as I understood what it meant, I thought, “Wow! I wish I’d known about that years ago. That perfectly describes my 6 years of marriage.” I’m hopeful that I can save you years of pain and frustration by sharing this information with you now.

The term comes from the 1944 black and white film, “Gaslight,” which I’ve actually taken the time to rent on Amazon and watch for myself. It’s dated, but still a wonderful psychological thriller, and I definitely recommend it. In the movie, the main character marries a man that seems perfect in every way. He’s charming, handsome, wealthy, and appears to be completely in love with her. After the wedding they move to his ancestral home where things slowly and insidiously start to unravel. The woman’s belongings keep going missing and appearing in strange places, and the gaslights (from which the movie gets its name) keep turning on and off at strange times.

When the woman tells her husband about these peculiar occurrences, he tells her that they aren’t actually happening and that she is losing her mind. He even goes so far as to get a psychiatrist to examine her and back up his claims of her insanity. His insistence on her mental instability is so pervasive that she actually starts to believe that she is going crazy until the big reveal in the end, when we find out what his devious plan was the whole time. I won’t spoil it for you.

“Gaslight” is a wonderful example of the slow, methodical and insidious nature of gaslighting. It’s a long game power play where the perpetrator slowly makes the victim question her/his own reality. The Psychology Today article, “11 Warning Signs of Gaslighting” by Stephanie A. Sarkis, PhD, describes gaslighting this way, “Gaslighting is a tactic in which a person or entity, in order to gain more power, makes a victim question their reality. It works much better than you may think. Anyone is susceptible to gaslighting, and it is a common technique of abusers, dictators, narcissists, and cult leaders. It is done slowly, so the victim doesn’t realize how much they’ve been brainwashed.” The slow and methodical nature of gaslighting is what gives it such power. Because of the steady and mounting message the victim receives that her/his senses can’t be trusted, it begins to feel like the truth.

11 Warning Signs of Gaslighting by Stephanie A. Sarkis Ph.D.

According to Sarkis, there are 11 warning signs of gaslighting to watch out for, and I’d like to explore them here.

  1. They tell blatant lies
  2. They deny they ever said something, even though you have proof.
  3. They use what is near and dear to you as ammunition.
  4. They wear you down over time.
  5. Their actions do not match their words.
  6. They throw in positive reinforcement to confuse you.
  7. They know confusion weakens people.
  8. They project.
  9. They try to align people against you.
  10. They tell you or others that you are crazy.
  11. They tell you everyone else is a liar.

Let’s explore these symptoms in more detail. I think that the first two make a good pairing. Gaslighters love to lie. They use it as a tool to confuse you. Even if you have a recording of them doing the thing that they’re lying about, they will continue to lie and tell you that it didn’t happen. They’ll do it with a straight face and belittle you for trying to stand up for yourself, truth and reality. Why do they do this? Well, because over time it makes you start to question the nature of truth and facts. It makes you think that maybe nothing in the world is certain, which is exactly what they want. When you no longer know the nature of truth, you are easily manipulated to believe whatever the gaslighter wants you to believe.

Number three, using what is near and dear to you as ammunition against you, is a potent tool. My ex-husband used to use my religion against me–attempting to control me based on religious beliefs about gender and relational power dynamics. I’ve worked with clients who intimidated their partners into staying with them by saying that they would take away their children if they left. Remember that this is a power and control tactic. It’s not based in reality, but because it touches on deep-seated fears, beliefs, or values it works to intimidate and control the victim.

Number four, “they wear you down over time,” is an important one. Gaslighters start out with a friendly and welcoming demeanor, and charm their victims into trusting them, and then over time begin to introduce their power and control tactics one subtle drop at a time. By slowly chipping away at the victim’s reality and relationship to truth, victims often don’t realize that their worlds have become more and more confusing until they don’t trust their own senses at all, which leaves them in the precarious position of looking to the gaslighter to tell them what to believe. This is exactly the outcome that the gaslighter wants.

Number 5 is probably the biggest give-away of a gaslighter. “Their actions don’t match their words.” They tell you that they are going to do something, and then they don’t do it. They tell you something was done, and you then find out that it wasn’t. They make promises that they don’t keep, and then they tell you that they never promised it in the first place. If you start to notice this trend, run!

Number 6, “They throw in positive reinforcement to confuse you” works like this. The gaslighter has told you that you’re crazy and don’t know anything one too many times, and you’re starting to think this person is a bully and you need to get out of the relationship, leave the company, or even the country. Then, suddenly the gaslighter does something nice for you, gives you a gift or a compliment, a tax break, etc. You think, “well, maybe they’re not so bad. Maybe I was over-reacting,” and then the gaslighting resumes even stronger than before.

As the victim’s confusion deepens, number 7 comes into play, “They know confusion weakens people.” Our ability to trust our own senses and interpretation of reality gives us a rootedness in life. By eroding your ability to trust that you know what is true and not true, the gaslighter is literally cutting you off at the root, leaving you weakened and dependent on them for support. That is the entire point of the gaslighting process.

Number 8, “They project.” This one is super weird when you experience it. You confront the gaslighter about bad behavior, and instead of taking responsibility, they accuse you of doing whatever it was that they did instead. For instance, my ex-husband used to accuse me of being bad with money when I would talk to him about the fact that he had just emptied our bank account. Gaslighters do this because it distracts you from the reality of what happened and makes you start defending yourself instead.

Number 9, “They try to align people against you.” This tactic may or may not be reality.
Gaslighters tell their victims that others are against them, and that the only person that the victim can trust is the gaslighter. Remember that they lie, so they may be making it up, but they may actually go so far as to poison people against you. I had an ex-boyfriend who called me “psycho-bitch” to anyone who would listen. By making people believe that I was crazy, he isolated me from my support system in an attempt to make me more dependent on him. This tactic also served to make people question the validity of my statements, especially about him and the way that he treated me.

Number 10, “They tell you or others that you are crazy.” I touched on this earlier, but this one is super important and bears repeating. I find that the operative word tends to be “psycho.” If anyone ever calls you psycho, run. If they call their exes psycho, run. If they call their family members psycho, run. Don’t look back. This person is very likely a gaslighter.

Number 11, “They tell you that everyone else is a liar.” Your world is already on shaky ground. You don’t know what is real and what isn’t anymore. You’re not sure that you can trust your own senses or that you’re mentally sound. Then, the gaslighter tells you that your family, the media, your friends, other countries, or some group are always lying to you. Since you don’t know what’s true anymore anyway, this gives the gaslighter the power to shape reality to his/her own benefit.

Anyone can fall victim to these tactics. This isn’t something that only happens gullible people. It happens to smart, educated and powerful people all of the time. If you’re reading this and recognizing that there is a gaslighter in your life, don’t blame yourself. It’s not your fault. Don’t try to change the gaslighter or reason with them. It won’t work. Just leave.

It will take time for the world to start to make sense again after being gaslit, and that’s OK. Give yourself the patience and gentleness that you were missing with the gaslighter while you heal and find your footing again. The important thing is to just be with yourself as long as it takes to get to the other side of healing.

The Healing Power of Yoga

It is my fervent belief that yoga saved me from a life of chronic illness, but when my neurologist at the time, Dr. Purcell, suggested it, I didn’t have any idea of the healing powers that yoga offered.  I was just so desperate to be well that I would have done anything that might actually help.  It was only later that I came to understand why yoga healed me the way that it did.  

It shocked me at the time that my nausea went away almost instantly after starting yoga classes.  I couldn’t account for it, but I was grateful for it beyond words.  The constant year-long nausea and vomiting had been the worst part of my illness, by far.  After that, I quickly re-gained the strength, stamina and motivation that had abandoned me, and I began to live again.

It took years to obtain the diagnosis that eventually led to a coherent treatment plan.  It wasn’t until well after I recovered that the label “spasmodic torticollis” came into my life.  I had to google it to understand exactly what it described, having never heard of it before.  It’s such an unusual and odd sounding term that when people ask for my diagnosis and I give it to them, they usually give me a blank look and say, “What was that again?”

In his book, Healing Yoga: Proven Postures to Treat Twenty Common Ailments—from Backache to Bone Loss, Shoulder Pain to Bunions, and More, Loren Fishman, MD has a fortuitous little blurb about my condition.  He writes, “A third condition that occurs in the neck isn’t as common, but if you’ve had it or even if you’ve seen it on someone else, you won’t forget it.  It’s called spastic torticollis—literally spasmodic turning of the neck.  It happens when one group of muscles gets really tight and turns the neck.  Sometimes the head turns in jerking motions, and sometimes it turns and stays in an unnatural place.” (Fishman 122-123).  

For some time after recovering from the worst of my illness, I had the jerking motions Dr. Fishman describes above.  My head would involuntarily turn to the right over and over.  It was embarrassing.  During the day, when I was in public, I would fight the head turning with everything that I had, and completely exhaust myself.  At home, when I was alone, I would relax and let my head do what it would, leading to half watched TV shows and great difficulty in keeping my place when reading.  Fishman writes, “This is a condition so painful and so intransigent that you may need a yoga therapist or a doctor who can give an injection that will alleviate it at least temporarily” (Fishman 122-123).  

Dr. Fishman’s assertion that spasmodic torticollis is extremely painful is, I think, the reason that my diagnosis and treatment took so incredibly long to obtain.  I don’t have much pain at all.  I have the odd headache, and my neck and shoulders tend to be a little bit sore, but I really don’t have significant pain.  In the very beginning of my illness, my ears and my scalp on the left side of my head hurt, making it difficult to sleep or wear a headset, but that pain went away fairly quickly.  

Doctors kept asking me about pain, and when I said I didn’t have much, they immediately dismissed me as a “hysterical woman” trying to get attention for something that wasn’t really very bad.  I would like to point out that pain is not the only thing that makes an illness terrible.  In fact, I probably would have preferred pain to the ongoing nausea and vomiting that I endured for a year and a half.  At least people that are in pain can eat, and they don’t starve to death.  

However, Dr. Fishman is right about the injections.  Every three months I go in to see my current neurologist, Dr. Matich, who is wonderful and warm and helpful, and she uses a machine to measure my involuntary muscle contractions.  She does this by inserting a probe into each affected muscle and listening to the sounds they create through a special machine.  Sometimes my muscles whoosh and growl like storms.  Dr. Matich then injects botox into the extra loud muscles to help them relax, and I can hear the muscle-storms grow calm.  Over time, this has been a helpful addition to my care, but I honestly don’t think it’s nearly as helpful as yoga.

In Healing Yoga, Dr. Fishman describes how “Laboratory and clinical studies have confirmed that pain from upper cervical joints and muscles can be referred to the head” (Fishman, 121).  I think this was exactly the complicating factor in my own illness.  I believe that what happened to me goes something like this: the whiplash injury that I endured caused the upper cervical muscles in my neck to go into spasm, which irritated muscles and nerves in my head, leading to migraine symptoms, but no pain.  I had the visual disturbance, nausea, vomiting and cognition problems that go with severe migraine, but the pain never showed up, which confused everyone—including me.

If he had known about me and my illness, I believe that Dr. Fishman would have backed up my neurologist’s suggestion that I treat my symptoms with yoga.  Dr. Fishman writes, “Appropriate yoga is good for almost anything that ails the neck and for pain referred from the neck to the head. . .  It improves suppleness of the neck muscles and increases the versatility of the joints so they can move more easily in many different ways.  It refines the coordination of the various muscle groups, so muscles aren’t pulling against each other with such ferocity” (Fishman, 123).  I believe that these benefits are part of the reason that I began to feel much better quickly after beginning my yoga practice.  With my neck muscles in spasm, I needed something to interrupt the process of pulling muscles irritating the tissues in my head, and yoga miraculously did that for me.

However, I think there was another contributing factor.  I think that the muscles, nerves, and other tissues in my neck and my head were terribly inflamed by the whiplash injury, at least partially causing the migraine symptoms.  Multiple studies have shown that inflammation is a leading factor in many of the chronic illnesses that people suffer from, such as fibromyalgia and chronic back pain.  Treatments for pain often focus on decreasing inflammation using NSAIDs (non-steroidal anti-inflammatories), such as over the counter ibuprofen, or stronger prescription versions, like Naprosyn.  Many people, including myself, take a daily turmeric pill, which is a spice used in some forms of cooking, because it’s been shown to have anti-inflammatory qualities. 

I didn’t know it at the time that I started my yoga practice, but yoga decreases inflammation too.  Dr. Fishman writes, “We physicians can’t do much apart from medication for swelling of joints; your body can do more by itself, using a molecule called PGC-1alpha. This is a potent endogenous anti-inflammatory that reduces swelling anywhere it occurs in the human body.  Gentle activities such as yoga and tai chi, and especially yoga done for long periods of time, encourage the body to release this miraculous substance from your muscles” (Fishman, 122).  The joints in my neck were certainly inflamed after the traumatic whiplash injury that I suffered, and I believe that getting involved in yoga significantly helped to reduce that swelling through the release of PGC-1alpha.  How miraculous!  

Because of its anti-inflammatory effect, I believe that yoga should be a frontline treatment for any physical ailment that is caused by inflammation.  Can you imagine the wellness that would result if doctors would prescribe yoga for arthritis, fibromyalgia, back pain, and any of the other ailments that they usually prescribe pain medication for?  I truly believe that the world would be a much healthier and happier place.

Speaking of happiness, I’d like to say a little about how chronic illness affects mood.  Dr. Fishman writes, “. . .chronic pain does more than cause people to lose days of work.  It’s depressing.  It produces anxiety.  It makes life so hard that sometimes it doesn’t feel worth living.  I think it’s extremely important to address pain that could be or is becoming chronic and end it as soon as possible” (Fishman, 86).  While Dr. Fishman talks about chronic pain being depressing, I would like to add that chronic illness is depressing whether pain is involved or not.  Before my injury and subsequent illness in 2011, I was the happiest I’d ever been.  I had found a group of people where I seemed to fit in completely for the first time in my life.  I was active and social and enjoying every minute of it.  Then, the whiplash injury happened, and my happy life became very small and extremely unpleasant.  

As I sought help, doctors kept telling me that my symptoms were the result of anxiety, and they kept pointing out how anxious I was in the appointments, and how sad and alone I was.  I argued that I was anxious because I kept seeking help from professionals who dismissed my symptoms, and I was depressed because I was terribly ill and unable to do the things that made my previous life so wonderful.  But the doctors continued to insist that my symptoms were the result of anxiety and depression, not the other way around.  I found this incredibly frustrating and demeaning, and it’s refreshing to have Dr. Fishman acknowledge that chronic illness leads to a life that doesn’t feel worth living, because it absolutely does.

However, it appears that the psychological effects of chronic pain and illness are even worse than I previously thought.  Dr. Fishman writes, “. . . there is a less-recognized reason: chronic pain that lasts more than a year seems to have negative effects that last much longer.  A study done at Northwestern University shows that a year of chronic back pain actually shrinks the gray matter in the brain by as much as 11 percent, the equivalent of ten to twenty years of normal aging, and that loss is directly related to the duration of the pain” (Fishman, 86).  Ten to twenty years of normal aging caused by one year of chronic illness!  Honestly, that blows my mind, but I’ve seen it happen.  

In my own case, after my illness went into remission, and I got treatment that made sense, it took a couple more years for me to be able to focus on reading a book, or to be able to write the way that I had prior to getting sick.  I’m sure that recovering from brain atrophy was one of the reasons that it took me almost 10 years to get my book project together.

My grandmother became ill within the past few years.  Within a year of getting sick, she went from a vibrant older woman who managed a home of her own and loved to sew quilts, to a woman who needed 24-hour care and couldn’t recognize her own grandchildren.  Now she’s living in a nursing home that specializes in dementia care, and I’m certain that her illness was a major contributing factor to her mental decline.

Truly, we must take chronic illness and chronic pain seriously.  It not only decreases life satisfaction, causes anxiety and depression, it actually causes brain damage.  The good news is that in addition to other wonderful effects we’ve already discussed, yoga can help with the terrible mood and brain problems brought on by illness.  Fishman writes, “Clinical trials confirm that yoga helps reduce distress and depression and promotes a sense of calm well-being” (Fishman, 191).  He also explains that yoga is being used to treat PTSD. “The Naval Medical Center in San Diego and other military VA hospitals are offering yoga to help Marines, soldiers, sailors and others wounded in Iraq and Afghanistan who are suffering from post-traumatic stress disorder.  Preliminary military studies have found that the calming effect of yoga can assist PTSD patients in dealing with hypervigilance, flashbacks, depression and anxiety” (Fishman, 201).  Honestly, I think yoga is the cure-all that people are looking for, but it is under-prescribed and under-utilized.

Please spread the word about the healing effects of yoga.  Even though it’s more work than taking a pill, I think it’s more than worth the effort.  It saved my life.  It could save yours too.  Dr. Fishman lists multiple ailments that he has personally and effectively treated with yoga, including: back pain (both neurological and musculoskeletal), rotator cuff syndrome, headache, weight control, bone health (osteoporosis), insomnia, scoliosis, premenstrual syndrome, depression, restless leg syndrome, bunion, and plantar fasciitis.  While this is an extensive list, I’m willing to bet that there are many more conditions that would respond positively to treatment through yoga, and I encourage you to give it a try.

The Importance of Belonging Instead of Just Fitting In

Depressed people often tell me that they spend most of their time pretending to be happy. They feel that they must–that it’s expected of them. They say that they are exhausted by keeping up the pretense of cheerfulness, and that it feels like a mask that they wear to fool the people around them into thinking that they’re “normal.”

Every time someone tells me that they wear a mask of cheerful pretense, the Beatles song, Eleanor Rigby pops into my head:

“Eleanor Rigby
Picks up the rice in the church where a wedding has been
Lives in a dream
Waits at the window
Wearing the face that she keeps in a jar by the door
Who is it for?

All the lonely people
Where do they all come from?
All the lonely people
Where do they all belong?”

Clearly this sense of wearing a mask to fool the world is not new or isolated. In fact, I would bet that we all have done it from time to time. Some of us are better at it than others. Personally, I’m terrible at it. When I try to pretend, I come off as cold and stiff, and everyone knows that I’m not acting normally.

Susan David, in her TED Talk, “The Gift and Power of Emotional Courage,” says that “being positive has become a new form of moral correctness.” She calls this “a tyranny of positivity.” I agree with her. Somehow pretending to be happy is seen as better than living an authentically felt life, and people are shamed for being “negative,” or displaying emotions seen as “bad.” As a result, people walk around wearing happy faces, but feeling dead inside.

You may wonder, what’s bad about pretending to be happy? Isn’t that the point of “fake it ’till you make it?” The answer is that pretending to be happy cuts us off from authentically connecting with other people, and authentic connection is one of the greatest and most basic needs of human beings.

Below is a picture of Maslow’s Hierarchy of Needs, which came up regularly in my college psychology courses. Starting from the bottom of the chart, you’ll see the most basic human needs for food, shelter, water, and clothing. Once those are satisfied, the next level is for safety. Directly after basic survival and safety comes love and belonging, including a sense of connection. Connection is not a luxury–something that might be nice to have one day. Connection is number 3 on the hierarchy of human needs. It’s that important.

Maslow’s hierarchy of needs, a scalable vector illustration on white background

However, there is a big difference between belonging and fitting in. Fitting in happens when people conform in order to be accepted into a group. Fitting in is that lonely feeling of wearing a face that you keep in a jar by the door. It’s the exhaustion that you feel after pretending to be happy all day when you want to cry on the inside. Fitting in does not fill that basic need for connection. Instead, it makes us feel even more lonely than being alone.

Belonging, on the other hand, is the feeling of ease that you have with a trusted friend. Belonging is the knowledge that it’s OK to show your authentic feelings, because the person that you’re with will understand and will continue to support and love you. It’s only in belonging that the basic need for a sense of connection is fulfilled.

In order to have true belonging, it’s necessary to be vulnerable, and while the idea of vulnerability may be so uncomfortable that it immediately makes you want to stop paying any attention to what I’m saying, please stay with me. This is important.

In her TED Talk, “The Power of Vulnerability,” Brene Brown explains that “in order for connection to happen, we have to allow ourselves to be seen. Really seen.” In order to feel that authentic connection that is one of our basic human needs, we have to be able to take off the mask, stop pretending to be happy when we aren’t, and show our true faces. The longer that you’ve been pretending, the more vulnerable this will make you feel.

When I work with clients on their need to belong, they often tell me that the idea of not pretending is preposterous, and that there is no way that they would allow themselves to be so vulnerable. I tell them that the fact that they had such a strong reaction tells me that vulnerability and the ability to be authentic is where the true work is for them. If you’ve had a strong reaction to the idea of being more authentically vulnerable with people, the same goes for you.

Now, I’m not suggesting that you go around telling your deepest darkest secrets to everyone you meet. Being vulnerable with people is a process. It doesn’t happen all at once. If there is someone that you think you might like to get closer with, reveal something small to them and see if they can handle it, and if they share something small with you in return. If so, try sharing something a little bit more personal, and so on. Creating true connection takes time, and you should only share your most personal stories with people who have earned the right, and have shown you that they are worthy. This is the way to build authentic connection with people who are safe.

Will there be times that you will pick the wrong person and get hurt? Of course there will be. However, building belonging in your life is worth the risk.

Belonging heals. In tribal cultures, when a member of the group is sick, the entire community takes part in the healing. The whole group comes out and dances around the fire, sings, or talks with the sick person. While these treatments aren’t necessarily scientific, people often do get well simply because the entire group showed up for them. Can you imagine how it would feel if your entire community showed up for you when you needed them?

Because so many people in Western culture confuse fitting in with belonging, and refuse to take the scary step towards vulnerability, the power of authentic belonging has eroded. When people are depressed or sick, they tend to end up more isolated than they were before their illnesses, and their isolation makes them sicker.

I would like to challenge you to examine your relationships. How many of them are based on fitting in and how many are based on true belonging and authentic connection? If you don’t have many authentic relationships, take the leap into vulnerability with the people that you feel have earned the right to it, and start building true belonging into your life. You’ll be glad that you did.

Healing Our Problematic Relationship to Anger Through Healthy Boundaries

Society’s relationship with anger is problematic as it’s an emotion that often gets confused with aggression. However, they’re not the same thing. Anger is an emotion that everyone experiences from time to time, and it’s perfectly healthy to do so. However, acting aggressively, while sometimes important for self protection, mostly causes unnecessary pain in the world.

When clients ask me to help them with anger problems, it’s frequently divided down gender lines. While there is some overlap between sexes, men tend to tell me that they lose their tempers too easily, yell, swear, frighten those around them, and sometimes hit–both objects and people. They ask me to help them to get a moment to pause and consider their behavior before they respond because their aggressive behaviors are damaging their relationships, or causing them legal problems.

Women, on the other hand, tend to tell me that they can’t access their anger. They say that people treat them terribly, but instead of becoming angry, they become sad or depressed. They blame themselves. These women feel immobilized by their own inability to get mad enough to set boundaries or create change in their lives and relationships.

I don’t believe that these gender differences in relationship to anger are actually biological. Instead, they are a product of society’s penchant for gendered child-rearing. Boys are taught that they are not allowed to cry; that tenderness, kindness and sadness are not masculine, and that the only acceptable emotions are happiness and anger. Girls are taught that they need to be nice and sweet and happy all of the time, and they tend to be punished more severely than boys are when they become angry or say no.

These gender stereotypes in relationship to emotions are extremely damaging. Boys that buy the message to “man up” (one of the most damaging phrases in the English language), end up unable to access hurt, sadness, kindness and compassion. Instead, they jump directly to anger when they feel any of the other emotions coming on. They believe that if they’re not happy, then anger is the only other acceptable thing to feel.

On the other hand, women who buy the “nice girl” message tend to have problems recognizing when their boundaries have been crossed. They tell me that they know that they should be angry, but they can’t access the feeling. Instead they blame themselves, thinking that they were somehow not good enough, and that if they could just be better, then people would treat them right. However, it doesn’t work that way, and they wear themselves to a nub trying to be “good enough,” (whatever that even means).

In therapy with the angry people, I work with them to pause when they feel the fire of anger rising within them and then feel into what lies underneath. Anger tends to be a secondary emotion that covers up an unconsciously rejected underlying feeling . For instance, instead of allowing feelings of hurt, a person may jump right over emotional pain and straight into anger. Other emotions people tend to bypass in favor of anger include: sad, vulnerable, rejected, and disrespected.

Once these angry people are able to tap into the underlying feeling, which can take a lot of work by the way, I encourage them to verbalize that feeling. Verbalizing it to the other person involved is best, if possible. However, if it’s not possible to tell the other person how you feel, saying to yourself, “Wow. I’m feeling really hurt right now, and it’s OK to feel that way,” is powerful. The more that these people do that, the more that they can override their childhood programming that anger and happiness are the only appropriate emotions.

On the other side of the coin, when I’m working in therapy with people who can’t access anger, I help them to give themselves permission to feel angry. What I’ve found is that these people often have anger and aggression confused. I explain to them that anger is healthy and normal, and that feeling the entire spectrum of human emotion, including anger, is a good thing. I help them to understand that being angry doesn’t have to mean that they behave aggressively. Sometimes, all it means is that they say, “Wow. That made me really mad!”

Then I work with them to understand the importance of boundaries in a relationship. Having bought into the idea that they have to be “good” and “nice” all of the time, they often fail to stand up for themselves when they need to, which is just as damaging to relationships as having angry tirades.

How is it so damaging, you ask? Well, here’s how it works. People that are trying to be nice all of the time tend to allow people to take advantage of them. If you’re thinking that other people shouldn’t try to take advantage, you’re right. They shouldn’t, but they do. Once these opportunists realize that the nice person won’t say no or get angry, they continue to take advantage, but also lose respect for them, leading to treating the nice person even more disrespectfully. If the nice person continues to try to curry favor with the disrespectful one, the relationship can become abusive. However, what often happens is that the nice person eventually builds up so much resentment that he/she lashes out uncharacteristically, or quietly leaves the relationship.

In the end the outcomes of both strategies are the same. The angry and aggressive person ends up alone because eventually people get tired of being bullied. The good/nice person ends up alone because he/she eventually becomes resentful enough about being taken advantage of to leave.

The solution to both of these problems is healthy boundaries. Here is an outline of the differences between healthy and unhealthy boundaries:

A. Collapsed Boundaries (The Good/Nice Person)

  • You can’t so no, because you are afraid of rejection or abandonment.
  • Your identity consists of what you think others want you to be. You are a chameleon.
  • You take on other’s problems as your own.
  • You share personal information too soon, before establishing mutual trust/sharing.
  • You feel responsible for other’s happiness and fulfillment and sometimes rely on your relationships to create that for you.
  • You compromise your values or beliefs to avoid conflict.
  • You tend to absorb the feelings of others.
  • You lose control of your emotions easily.
  • You have no balance of power in relationships. you tend to be either overly responsible and controlling or passive and dependent.

B. Rigid Boundaries (The Prickly Person)

  • You are likely to say no if the request involves close interaction.
  • You avoid intimacy (pick fights, stay too busy).
  • You fear abandonment OR engulfment, so you avoid closeness.
  • You rarely share personal information.
  • You have difficulty identifying wants, needs, or feelings.
  • You have few or no close relationships. If you have a partner, you have very separate lives and virtually no shared life.
  • You have difficulty asking for or receiving help from others.

C. Healthy Boundaries

  • You can so no or yes, and you are OK when others say no to you.
  • You have a strong sense of identity. You respect yourself.
  • You expect reciprocity in a relationship–you share responsibility and power.
  • You know when the problem is yours and when it belongs to someone else.
  • You share personal information gradually in a mutually sharing/trusting relationship.
  • You don’t tolerate abuse or disrespect.
  • You know your own wants, needs, and feelings. You can communicate them clearly in your relationships.
  • You are committed to, and responsible for, exploring and nurturing your full potential.
  • You are responsible for your own happiness and fulfillment. You allow others to be responsible for their own happiness and fulfillment.
  • You value your opinions and feelings as much as others.
  • You know your limits. You allow others to define their limits.
  • You are able to ask for help when you need it.
  • You don’t compromise your own values or integrity to avoid rejection.

If you recognized yourself in either the collapsed or the rigid categories, don’t be too hard on yourself. Knowing that boundaries are a problem for you is an important first step, and you can start today to work towards learning how to set healthy boundaries for yourself. My boundaries tend to be on the collapsed side, but they’re getting better all of the time, and I congratulate myself each time I say no to something that I don’t want to do, even though my impulse is to say yes, because this is what progress looks like.

You may also notice that your boundaries fall into different categories based on the relationship or the setting. For instance, you may have rigid boundaries at work and collapsed boundaries at home. Or, you may have collapsed boundaries in romantic relationships and healthy boundaries with friends. This is completely normal. As Louise Hay says, “the point of power is always now.” You can start today to change these behaviors and work towards happier and healthier relationships.

Be gentle with yourself as you start to make changes to your boundaries. This is a process. If you find yourself being unnecessarily harsh as you start learning to say no or ask for what you want in a healthy way, just acknowledge it and try again. This could look like, “Whew, that came out a little rough, let me try that again.” Usually people are extremely understanding when you explain that you’re working on a personal growth project.

As your boundaries get healthier, you’ll notice that your relationships with others become healthier, and that you attract healthier people and experiences into your life. It’s worth the work, and I encourage you to get started now.

Shame: How it Affects us, and How to Overcome it

Over the weekend I went out of town to attend my 2-year-old niece’s birthday party. She was adorable, and I enjoyed spending time with my family, but the drive through LA can be brutal. On my way home, a man on a motorcycle whizzed by me and then flipped me off. I have no idea what I could have done to make him angry. I had been driving in the same lane at the same speed for miles.

Despite the knowledge that I hadn’t done anything wrong, I felt hot shame flush through my body, and I recognized the sensation as one that I’ve experienced frequently lately. It seems like every time I turn around these days, someone is suggesting that there is something wrong with me.

Whenever I make a comment online, dozens of perfect strangers attempt to shame me by calling me stupid in myriad ways. Partly, I think that people shame others in order to dispel some of their own frustration, but I also think that they do it believing that the shame will teach the other person a lesson.

I’ve seen parents shame their children for the same reason. Children who get bad grades or fail to do their chores properly are often shamed by their parents, who believe that the shame will get their children to behave better in the future.

Unfortunately, these parents’ efforts are misguided. Shame can’t teach anyone anything. Scans of human brains show that the learning centers shut down on shame. No information is getting in until the shamed person’s brain calms down. If the goal is teaching, it is much better and more effective to speak kindly to people, and help them to understand and practice. A relaxed brain is a learning brain.

Brene Brown, the renowned shame and vulnerability researcher, defines shame as the “intensely painful feeling or experience of believing that we are flawed, and therefore unworthy of love and belonging.” This sense of unworthiness is profoundly damaging to the human psyche. The more that people receive the message that they are unworthy of love, the more that they believe it. Much of my work as a therapist is helping people to undo the programming of shame.

While shame usually begins as damaging messages of unworthiness from the people around us, over time we tend to internalize the shame and begin shaming ourselves. We believe that we need the shame to motivate ourselves–to keep ourselves from becoming lazy couch potatoes.

However, the research shows that shame doesn’t actually motivate people. The more that we shame ourselves, the more depressed we become, which leads to lower levels of motivation, not higher. Giving ourselves kindness and compassion is a much better way to gain motivation.

If you’re thinking that you don’t have shame, think again. Shame is universal. The only people that don’t feel it are psychopaths. The more that we act like shame doesn’t exist, the more it grows. Speaking honestly with each other about the experience of shame is the only way to overcome it.

Brene Brown talks about shame being like a Gremlin. In the 1980s movie, Gremlins, the little green monsters that wreak havoc are only killed in the end by the sun. Shame is the same. It is only by exposing it to the light that it can be defeated.

I’m not suggesting that you start telling everyone you meet about your shame experiences. Doing that would likely just create more experiences to be ashamed of. Instead, share your shame with people who have earned the right to hear your stories, and have the emotional strength to bear the weight of your pain.

These are people who have stuck with you through good times and bad times, and have shown that they can be trusted with your secrets and your pain. If you can’t think of anyone like that in your life, I would suggest that you find a therapist who is trained to hear your shame stories and can help you shed necessary light on your pain.

There’s an important difference between shame and guilt that I’d like to discuss. While shame is the terrible feeling of being unworthy of love and belonging, which is harmful and leads to painful experiences of disconnection, guilt is the knowing that you have done something wrong that you need to make right somehow.

Shame is the sense of “I am bad,” and guilt is the sense of “I did something bad.” Unlike shame, guilt can help people to rebuild connections. When people realize that they have hurt others, they can apologize and seek forgiveness.

If you regularly speak to yourself in the language of shame, I would encourage you to begin practicing self-compassion. If you’re constantly shaming yourself, your nervous system is constantly in fight or flight mode, which is extremely damaging to your body and your nervous system. In this self-protective state, you will have difficulty learning new things, and your body will likely become depressed in order to deal with all of the stress.

Self-compassion is a wonderful way to begin the process of coming out of a self-shaming mind state. There are three components to self compassion: 1) mindfulness, 2) self-kindness, and 3) common humanity.

The mindfulness part is about paying attention to your experience and noticing your self-critical and shaming thoughts. The self-kindness part is really about telling yourself that both you and your feelings are OK. And the common humanity part is reminding yourself that the experience of pain and shame are what make us the same as others, not different.

A self-compassion statement might look something like this: “Wow, I’m feeling a lot of shame right now. It’s OK to feel that way. Many people would feel shame in this situation.” You can create a self-compassion statement that works for you as long as it has all three components. It doesn’t take a lot of time to use the statement, and it can dramatically shift the experience of shame, and reduce your stress.

Despite the messages that you may have received over the course of your lifetime, you are worthy of love and belonging. You don’t have to do anything to become worthy. You are already worthy simply because you are a human being. Babies know that they are worthy of love, and so do the people around them. It seems strange to me that people think that at some unknown point in human development this inherent worthiness goes away. It doesn’t. All people are worthy of love and belonging, including you.

For more information on shame, please look into the work of Brene Brown. She’s one of my sheroes, and I highly recommend her book Daring Greatly. She also has two great TED Talks: “The Power of Vulnerability,” and “Listening to Shame.”

For more information on self-compassion, I recommend the work of Kristin Neff, who has a wonderful TED Talk called “The Space Between Self-Esteem and Self-Compassion.”

Overcoming Tribalism and Moving Toward Understanding

In a year where I feel like I’m huddled in the quiet place at the center of a tornado, I’ve been spending a lot of time watching the swirling whirlwind around me and marveling at its cruelty. Whenever I venture a little out of my comfortable quarantine space, bad things seem to happen. A few days ago I commented on an article online, and every day since, I’ve been barraged by people accusing me of intellectual, educational and moral degeneracy. These people don’t know anything about me except for one line of text, and based on that they feel entitled, and even morally obligated, to treat me like an enemy.

What’s more, I understand the urge. Sometimes people express opinions that fill me with righteous anger, and I wonder how anyone could possibly think the way that person does. Unless I consciously push back against the hardwired workings of my brain, it will automatically put that person I disagree with into the category of “other,” a person who is not part of my tribe, and not to be trusted.

Our brains evolved to classify people in this manner in order to keep us safe. When confronted with someone new, our brains will almost instantaneously assess that person’s appearance, demeanor, and attitude, and decide if that person is “us” or “other.” This was a matter of life or death in antiquity. Someone from a neighboring tribe would quite likely be an unsafe rival who competed with us for food and other resources, and they could be dangerous to our physical safety.

Unfortunately, as the centuries progressed, this hardwiring to the ancient structures of our brains didn’t change, and people still unconsciously continue to assess those that are unlike them to be threats. We can easily see this behavior in teenagers who form cliques that are fiercely loyal to each other, and who roam school hallways together looking for “others” to crush.

While people gain identity, safety, and companionship from being part of the group, they may also be stifled by it. Those that don’t conform to the group norms can end up ousted from the group, and find themselves in the cold and frightening role of “other.” As a result, people stop being creative, stop growing and changing, and stop trying to understand those who are different from them in order to avoid losing their safe place as part of the tribe. Sometimes, people will even do things that go against their own moral codes in order to remain in good standing with the group.

While we may not form cliques as often as we get older, we still join and conform to tribes. It may be a political party, a career path, an ethnicity, a religion, or even a family group. Our identities become bound up in these groups and we’re hardwired to see people in other groups as “the other” and somehow threatening to us, even if they actually have no intention of harm.

As people become more and more identified with their tribes, they lose objectivity, and they can be easily manipulated into hating the other group. Unethical people who are looking for power will often use this all-too-human tendency to unite against an “other” to rally people behind them. This process is extremely dangerous. Throughout history we’ve seen what happens when groups of people are demonized, labeled and feared: genocides, civil wars, concentration camps, witch burnings . . . the very worst of human atrocities. They all happen because of this hardwired tribalism.

So what’s the fix? How can we intervene? Well, the first step is to start paying attention. First, pay attention to the messages within your particular groups. Who is it that is being placed in the role of “other,” and who is benefiting from placing people in that role?

Next, pay attention to the feelings in your own body. If you feel comfortable with the messages of one particular group, but the other group’s messages make you feel physically uncomfortable, that’s not a sign that the other group is bad. It’s a sign that you have become so aligned with the beliefs of your own group that the way people from other groups see the world feels alien to your nervous system. Instead of further rejecting the worldview of other people and seeing them as wrong, grow curious. Start investigating other ways of thinking and believing. The more that we understand other people, the more we can embrace their differences.

Read books about topics that you’re uncomfortable with, and by people who you don’t agree with. Talk to people from the other group with an open and compassionate heart and mind, and try to understand why they see the world the way that they do. Nobody arrives at their beliefs in a vacuum. They’ve had life experiences that led them to where they are now. Understanding and knowing those stories breeds compassion, and we are in desperate need of compassion right now.

In my work as a therapist I talk with people from every imaginable group, and I can tell you that suffering, and a need for understanding are universal. Showing understanding for someone in a group different from yours is healing for everyone involved.

So, next time you’re online and see someone posting an opinion that you don’t agree with, instead of pelting them with insults, I encourage you to ask them why they believe what they do, and ask it with a truly open mind. If they answer, it might not change your mind, but it might help you to have understanding and compassion for a different way of seeing the world. It might help you to bring that person out of the “other” category and into the “us” category.

The truth is that we are all human, and while seeking out the differences between us in order to categorize, label and oppress people might be part of our hardwired nature, I believe that we have the capacity to rise above our hardwiring and make choices. People do it every day. They choose not to punch that person that made them angry, or ram that car that cut them off. We have the capacity to choose our behavior because of our amazing frontal lobes, which give us reason and self-awareness. I encourage you to start viewing people as a tribe of humankind in all of its wondrous and beautiful variety. Maybe then we can start treating each other with true humanity.

The Real Reason that Abusers Abuse: It’s Not Why You Think

One of my therapeutic specialties is helping people to work through abuse trauma. I honed my skills working in a domestic violence shelter, and also with Child Welfare Services, but I find that wherever I go, abuse trauma patients follow.

While there is endless variety in the types of abuse traumas that people have experienced, as well as the severity and duration of their abuse experiences, there always seems to be one underlying theme: a sense of shame and personal responsibility.

No matter how often I hear it, I never cease to be shocked by victims of sexual abuse who tell me that they somehow are to blame for their assaults, or the survivors of domestic violence who tell me that if they could have just been better spouses, their relationships could have been saved. These people tell me that their abusers must have seen that they were inherently flawed or unworthy, and that’s why they were chosen to be victims.

At first I would gently tell these people that they were mistaken, and that there was nothing wrong with them, but I quickly learned that the message that they were somehow to blame for what had happened to them was so deeply ingrained that they couldn’t take in any message that contradicted this belief.

That was when I had an epiphany about abuse. It’s not an action. It’s a process. Abuse is a process where the victims are slowly groomed to believe that they are at fault for their mistreatment. It’s an insidious message that starts out small, and grows over time. Abusers slowly push out other supports from the lives of their victims until the only message that can be heard is “You deserve this mistreatment because you are inherently bad and unworthy. If only you could be better, it would stop.”

Having victims who believe this message serves abusers in three ways:

  1. The victim is constantly trying to please the abuser. As a result, the abuser gets catered and deferred to. Depending on the type of abuse, the victim may also be afraid to contradict or stand up to the abuser, giving him/her the benefits of complete power and control over what should be a mutually beneficial relationship.
  2. It takes the blame off of the abuser for the abuse and puts it on the victim, so that the abuser can feel blameless and entitled to continue the abuse.
  3. It keeps victims from leaving because they truly believe that they are unworthy of respectful love, that they deserve the mistreatment, and that they are lucky that the abuser stays with them.

When people tell me now about the deep sense of shame that they feel about the abuse that they’ve suffered, I say, “Yes. That’s the message of abuse. Abuse says that you are somehow to blame for what has happened to you, and that if you were somehow better the abuse would stop. However, think about all that you did to try to be better and how none of it made the abuse stop. The message that you’re to blame is a lie that abuse tells.”

Usually, they nod and say, “Yes. It was just like that.”

Once they understand the message of abuse, I explain how it benefits abusers to get their victims to believe that they are the cause of the abuse. That’s when the healing begins.

There many of myths out there about abuse, and I would like to address some of them here:

  1. Abuse doesn’t happen because the abuser lost control of his/her temper. Abuse is a process. It is pre-meditated and thought through. Abusers behave the way that they do in order to get the benefits of abuse.
  2. Abuse doesn’t happen because of alcohol/drug use. Often, both victims and abusers will minimize abuse saying, “Well, he/she was drunk. He/she wouldn’t do that when sober.” Often in these cases the victim pushes the abuser to get clean thinking that will stop the abuse. If the abuser does get clean, the victim is often shocked that the abuse doesn’t stop. What they had failed to understand was that the abuser wasn’t abusing because of the substance. He/she was using the substance as an excuse to abuse and reap the benefits of abuse listed above.
  3. Victims do not enjoy being abused. They don’t stay because they like it or get some kind of thrill out of it. They stay for any mixture of the following reasons: a) They truly believe that they are bad people and nobody else will want them; b) They have become so isolated by the behavior of the abuser that they believe they have nowhere else to go; c) The abuser has convinced them that they cannot survive on their own; d) They are completely financially dependent on the abuser and cannot see a way to support themselves on their own. e) The abuser has threatened to kill them, take their children, or deport them if they leave, and they are afraid that he/she will follow through on these threats.
  4. Abuse can happen to anyone, regardless of race, socio-economic status, gender, education level or sexual orientation. It’s something that happens to people just like you.

If you’ve recognized yourself here, know that there is help for you. Even if you don’t have any money or any family or friends that you can go live with, there are shelters that will take you. The wonderful thing about going to a shelter is that they can connect you to a transitional living program. These programs are specifically designed to provide shelter, food, funding, and education for survivors of abuse so that they can rebuild their lives, including finding a career and learning how to support themselves. Don’t continue to wait for things to get better. They won’t. Pack a bag, take your children, and go to a shelter. Your life will immediately improve and you will be able to take your power back.

Read the book, Why Does He Do That by Lundy Bancroft. This is the best book about abuse I’ve ever read. Lundy Bancroft was the director of an abuse perpetrator’s program, and he has first-hand knowledge about the way that abusers think. Any time that I’ve been working with an abuse survivor who has read this book, she/he has gathered the courage to leave, and set down at least a portion of the shame she/he had been carrying. Understanding that abusers abuse in order to get the benefits of abuse is an empowering piece of knowledge.

Call the National Domestic Violence Hotline at 800-799-7233.

Call the National Sexual Assault Hotline at 800-656-4673.

Go to http://www.RAINN.org. RAINN is the nation’s largest anti-sexual violence organization, and they have resources for survivors.

Survivors of childhood abuse, I recommend getting involved in your local Adult Children of Alcoholics (ACA) organization. They don’t just help the children of alcoholics. They are a 12 step organization for overcoming the effects of all types of childhood abuse.

Know that you are not alone. There is help and support, and if you access it, things will get better.

It’s Not “Just” Depression

Something that I hear a lot, and often from people that should know better, is “well, it’s just depression.” I hear this in many different contexts, for example, a woman who has been having GI issues goes to see her doctor, who tells her that there really isn’t anything wrong with her digestive track, “it’s just depression.”

According to http://www.dictionary.com, the word “just” has several meanings, but in the above context it means, “only or merely.” That doctor could have easily substituted the word “merely” for “just,” as in “there isn’t anything wrong with your digestive track, it’s merely depression.” Then, said doctor refers the woman to see a therapist, and thinks that the problem is resolved.

Only, it’s probably not resolved. In these cases, people often continue to have health problems. If they do seek help from a therapist, they get suggestions about handling stressors, but therapists can’t treat physical symptoms directly. It’s possible that with time and work the symptoms will resolve, but it’s also quite likely that the patient will continue to struggle with health problems.

Unfortunately, after having their symptoms dismissed as “just” depression, people are unlikely to seek medical attention again because it’s too embarrassing to be dismissed like that. If they do seek medical treatment, they’ll likely see a different doctor, and the first one never learns that the referral to a therapist was unhelpful in resolving the symptoms.

It’s true that emotional symptoms can manifest as physical health symptoms, but the unfortunate fact is that doctors jump to this conclusion much too rapidly, without testing, and make a diagnosis based on opinion instead of on evidence.

If the physical symptoms are truly caused by mental health issues, there are often things that doctors can do to alleviate symptoms while the patient works on underlying mental health issues. However, due to their own inherent bias that it’s “just” mental health problems, they choose not to treat. In my own case, it truly was a physical problem, but since the doctors couldn’t easily fit my symptoms into a tidy box, they told me that the symptoms weren’t medical, and were “just” anxiety, and told me to see a therapist. It took me months and multiple doctor’s appointments with different doctors to get the anti-emetics that I needed so that I could keep food down. That’s months of illness that could have been avoided if doctors had simply taken me seriously enough to even treat my symptoms.

While all of this is bad enough, the medical system’s dismissal of mental health symptoms as not being worth treating bleeds out into the public attitude that mental health symptoms are made up and imaginary, leading to advice from well-meaning loved ones such as, “Well, you just need to get over it,” or “just focus on the positive more. You’ll be fine.”

That’s not how it works. People with mental health symptoms aren’t stupid. They’ve tried taking walks, thinking positive, remembering that the weather is nice, and all of the other too-easy fixes that people suggest to them.

Depression is complex. It takes work and time to overcome, and acting like it’s not serious or is easily conquered makes people with mental health problems feel even more alone than the depression tells them that they are already.

The truth is that depression is a serious disease with a death count. People die of depression in alarming numbers. According to the World Health Organization, more that 264 million people worldwide suffer from depression, and “close to 800,000 people die due to suicide every year. Suicide is the second leading cause of death in 15 to 29-year-olds.”

This idea that it’s “just depression” is a serious barrier to sick people getting the care that they need. An alarming number of patients with depression refuse medication saying that they “don’t want to be dependent on a drug to feel happy.” They wouldn’t refuse other life-saving medications for physical health problems, but they refuse medication for depression because of the idea that depression is something that they “should be able to overcome on their own,” and isn’t really serious.

It is extremely serious.

When people suicide, the big question that as themselves is, “but why would they do that?” People point to the fact that they had everything to live for, and seemed happy.

The answer to this question is that people suicide because they are depressed. It really is that simple. Depressed people can fake happiness quite well in order to get by in the world, but that doesn’t mean that they aren’t depressed.

Conventional wisdom says that depression means that the person is “just sad.” People think, “well, I’ve had the blues before too, and it went away.” Depression doesn’t work that way. Often people that are depressed don’t feel sad at all. Depression often presents with anxiety or irritability, but there is one underlying truth with depression–it tells you that you’re terrible and people don’t care about you. In severe cases, depression says that the people in your life would be better off without you, and might even be relieved that you’re gone.

It doesn’t matter how much external proof there is that these thoughts aren’t true. When someone is depressed, these thoughts feel like truth, and anything that contradicts them feels like lies. This is why people die of suicide. It’s not that they’re selfish or weak. It’s that they truly believe that the people in their lives will be better off when they’re gone because depression says they are terrible people, and it feels like truth.

Another ironic truth about depression is that one of the main symptoms is a lack of motivation. A person suffering from depression might not feel sad, but will likely have a difficult time getting motivated to do things. If they are able to accomplish things, depressed people get very little enjoyment out of what they do.

This makes treating depression complicated. It may be that the sick person has seen a therapist and gained knowledge of skills and behaviors that would help, but can’t seem to get enough motivation to perform those behaviors. They are not being lazy. Lack of motivation is one of the most common symptoms of depression.

When motivation is an issue, the best approach is often to start the patient taking antidepressants in order to get the small amount of motivation needed to start applying the skills they are learning in therapy. Antidepressants are important in the treatment of depression in order to increase motivation to do the work to get well, which is why it’s so important to remove the stigma associated with taking them. Antidepressants truly do save lives, and a combination of medication and therapy is often the most effective approach.

If there is a depressed person in your life, the best thing that you can do is reserve judgment and refrain from advice giving. Simply sit with the person if that is all that they are able to muster the motivation for. If the depressed person speaks, just listen. Don’t tell them that they aren’t thinking correctly, and please don’t tell them to get over it or just get outside or be more social. A little-known truth about depression is that hearing unhelpful advice makes the depressed person more depressed. It confirms their depressed thoughts that they are alone, nobody understands them, and people would be better off without them.

So what can you say? Express your willingness to be with them even thought they aren’t happy right now. Tell them that they are loved and important. Encourage them to seek professional help, but stop there with advice giving.

Here is a list of great things to say to depressed people:

  • What you’re going through right now is really hard.
  • I’m here for you.
  • I love you.
  • What can I do to help?
  • What do you need right now?

If they don’t know what they need, that’s OK. The fact that you asked is what’s important. It shows them that you care about them and that you’re willing to listen. Being present with a depressed person is probably the best help that you can give.

Remember, it’s impossible to talk someone out of being depressed, and trying to do so makes the depressed person feel alone and misunderstood, so don’t try.

If you are a depressed person, I urge you to seek professional help. I know that it feels like you shouldn’t have to, but that’s the depression speaking. When your therapist gives you skills to learn and homework to work on, give it your best shot. It may feel silly or like a lot of work, but there is a good reason for it. Your therapist is helping you to create new pathways in your brain that are healthy and move you away from the pathways of depression that are so well worn and easy to walk down. Remember that small movements forward are progress, and give yourself credit for every baby step.

If you are feeling suicidal, know that what depression is telling you about yourself and the people around you is a lie. The people in your life do love you and care about you and will be devastated if you are gone. You are worthy of love and belonging simply because you’re human. You don’t have to do anything to deserve it. Immediately take yourself to your nearest emergency room, or call a suicide helpline. If you can’t muster the motivation, call 911 and professionals will come to you.

The National Suicide Prevention Lifeline phone number is 1-800-273-8255, and it is available 24 hours a day. Call.

Let’s all start treating depression as the serious and life-threatening illness that it is. It’s not “just” feeling sad. It’s not fake, selfish or weak, and changing the public attitude towards mental health problems will save lives.

Here are some resources for more information:

Doing Harm Website

Compassionomics TED Talk

TED Talks on Depression

World Health Organization’s Depression Page