Self-Compassion: The Antidote to Perfectionism and Self-Critical Thinking

Perfectionism is often worn like a badge of honor by the overachievers of the world. While people realize that perfectionism can keep them in a spiral of self-critical thinking, the thought process often goes, “but if I keep criticizing myself, I will improve. I will become the version of myself that I truly want to be, and what could be wrong with that?”

Unfortunately, there are several problems with it. First of all, perfection is an unattainable goal. Humans are innately imperfect. That is what it is to be human, so the search for perfection will never end. Even you did manage to perfect one part of your life, there is another part waiting and ready for you to start worrying about next.

The second problem with perfectionism is that it leads to all kinds of mental health problems. Constant self-criticism leads to eating disorders, anxiety, and depression, just to name a few. People often think that their perfectionism and self-criticism are helping them to be motivated, but it works in just the opposite manner. By punishing yourself into your own depression, you’re putting yourself into the least motivational mind state possible. People with depression often have difficulty even getting out of bed, let alone performing at impossible levels of perfectionism.

It may seem counter-intuitive, but self-compassion is a much more effective way to improve both performance and mental health.

So what does self compassion mean? Well, there are three components: Mindfulness, Self-Kindness, and Common Humanity.

Mindfulness means being in the present moment without judging that moment as either good or bad. In order to work on being kinder to yourself, it’s important to be able to be present with your own thoughts, and to catch yourself being self-critical. This can be a tall order for some. Many people spend most of their time trying to escape their own inner thoughts by being in a constant state of distraction.

Often the perfectionistic mindset makes being present with our own mistakes and self-criticism much too scary. If the goal is to be perfect, admitting that we’ve fallen short of our own ideals can lead to more self-critical thoughts. The problem with this is that it keeps people from growing. In order to learn and grow, we have to be able to admit that there are parts of ourselves that are in need of work, which leads to the second component of mindfulness.

Self-Kindness means giving to yourself the same kind of gentle concern that you might give to a beloved family member or close friend. If your loved one came to you saying that they’d made a big mistake and that they were mentally beating themselves up about it, the kind response would be to something like, “It’s Ok. We all make mistakes. I still love you.”

Self-compassion is about taking that same kindness and giving it to yourself. Many people balk at this idea and say, “But that’s just letting myself off the hook.” However, it doesn’t really work that way. By giving yourself kindness about your own mistakes, you give yourself permission to actually see the places in your life where you need to grow. Instead of beating yourself up internally over every minor flaw to the point that you don’t even want to look at them, self-kindness allows you to examine mistakes and realize that they are just opportunities for learning, and that you’re still a good person no matter how many times you mess up.

What an amazing way to give yourself permission to try something new, to take risks, to approach new people. If it doesn’t work out the way you’d hoped, it’s not a reflection on your own worth anymore. It’s just part of being human.

Which leads us to Common Humanity, the final component of self-compassion. Common Humanity means realizing that everyone on this beautiful Earth is just imperfect as you are. All of those mistakes and errors that you make, don’t make you different or wrong. All of those imperfections about your body or your character or your relationships actually make you the same as other people.

When we beat ourselves up about mistakes, it can lead to feeling outside of humanity. We can look around at other people and think things like, “Well, they have their lives together. What’s wrong with me?”

The answer is that there is nothing wrong with you at all, and those other people are making just as many mistakes as you are on a daily basis. Everyone is just doing the best that they can with the resources and knowledge that they have in the moment. Realizing this truth can feel like a great relief! You are not alone in your imperfection. Instead, your imperfection is what makes you just like everyone else.

A very simple way to start practicing self compassion in your own life is to make a self-compassion statement that incorporates all three components of self-compassion. Here’s an example:

Let’s say that you are in the middle of trying to learn something new, and in the process you do something that wasn’t as skillful as you would have liked. Perhaps your go to response to this situation would be to say something to yourself like, “Come on! You know better than that! Why can’t you get this right? You’re so stupid!”

Unfortunately, if you continue to speak to yourself this way, you will probably give up your new endeavor because continuing to try only to mess up makes you feel terrible about yourself.

This process of self-criticism keeps you from growing and expanding into new ways of being you. When you notice this happening using your mindfulness skills, don’t judge yourself for judging yourself and make things even worse. Instead, use your self compassion statement as follows.

“OK. I’m feeling stupid right now because I made a mistake, and I’m being hard on myself about it. However, making mistakes is OK. It’s actually what makes me human, just like everyone else.”

This self-compassion statement is brief. It only took a second or two to say, but it shifted the entire experience.

Let’s break this statement down into its three component parts.

  1. Mindfulness: Recognizing the emotion (feeling stupid) and the self-criticism that went along with it.
  2. Self-Kindness: Telling yourself that what happened is OK. There is absolutely nothing wrong with you because of what happened.
  3. Common Humanity: Reminding yourself that everyone goes through situations like these. These experiences are what make you the same as others, not what makes you different or unworthy.

Using these three components of self-compassion, you can formulate a self-compassion statement that works for you, in your own voice.

Sometimes, when people hear about self-compassion for the first time they think it’s selfish. They’ve been raised to believe that being kind to others is a good thing, but being kind to oneself is wrong, and perhaps even sinful. However, people that practice kindness to themselves are actually kinder to others. People that are mentally healthy are more able to care for others in the world. By being open-hearted to yourself, you will be more able to be open-hearted to others.

It will likely feel weird and uncomfortable at first. That’s OK. Everything new feels weird at first. Normal is simply what we’re used to.

That self-criticism pathway in your brain is likely so well-worn that it feels comfortable and easy to walk down it, even though it is harmful to you. Creating new pathways in the brain is difficult and takes a lot of work and practice, even when the new way of thinking is good for you and will make your life better in the long run. Don’t give up on being more self-compassionate just because it’s hard at first. Put in the work. It’s worth it. You’re worth it.

For more information on self compassion vs perfectionism, here are some links to check out:

Kristin Neff’s Self-Compassion Website

TED Talk on the Dangers of Perfectionism

Link to Brene Brown’s book, The Gifts of Imperfection

Link to Kristin Neff’s Ted Talk on Self-Compassion 

Link to Kristin Neff’s book “Self-Compassion”

Stormy Weather in my Muscles and the World

In 2011 a severe neck injury left me incapacitated.  Not with pain as most people expect from neck injuries, but with an illness with all of the symptoms of a severe migraine, but without the pain.  I couldn’t hold any food down, eating was revolting, my vision was often blurred or doubled, and my thought process was so terribly impaired that I often couldn’t make simple decisions, like whether to turn right or left.  This went on for over a year-and-a-half without explanation or relief, until an inspired neurologist suggested that I begin practicing yoga, and my healing ensued.  I maintain that yoga saved my life.

Through a lot of hard work and time, I’ve healed to the point that I live my life fairly normally.  Eating is enjoyable again, and I can keep my food down.  I love my body in a completely new and different way after realizing that having a few curves means that I’m healthy enough to eat the delicious food around me, which sustains me and feeds my curious mind.  Working isn’t a problem because my thought process and ability to make decisions has been restored, and while the aging process has led me to need reading glasses for close work, my vision is normal again.

However, there are some frustrating and somewhat embarrassing chronic problems that I deal with every day.  The most visible is the fact that the injury to my neck distorts my face a little bit.  Probably most people think that it’s just how my face was made, but whenever I look in the mirror, and especially when I see myself on film, I cringe a little bit.  While I used to have even features, post injury, the lower half of my face pulls to the right, which distorts my mouth and gives me a slightly lopsided appearance.  I do my best to love my face anyway, and thank my body for healing to the point that I can live my life normally again, but I have to admit that it rankles some that my face bears the mark of my illness so clearly for all to see.

The worst of the chronic symptoms left behind by my injury and illness plays out in my sleep.  The stress on the muscles of my face and jaw cause clenching, and I have to wear a mouth guard.  Still, I wake up many mornings with an aching face and jaw.  Yet, it’s something else that plagues my rest.

It started to happen just as the nausea, vomiting, thought process and vision problems began to subside; a strange, involuntary pulling in my neck muscles that turned my head to the right, back, and to the right again, like a tic.  It was humiliating when the women who sat behind me at work noticed.  I could hear them talking about it behind my back.  One even ventured as far as to ask me if I was OK when I was having a particularly difficult pulling episode.  I simply said I was fine.  A lot of the time, the pulling made me want to close my eyes.  It was difficult to keep them open, and when I was alone, I would sometimes sit for hours with my eyes closed, allowing my head to move how it wanted, instead of straining to keep it straight to avoid the humiliation of people staring and whispering.

In addition to the pulling and tension, which I have learned to push back against so most people don’t notice, there is a sensation of moving and crawling under the skin of my upper back and neck.  This is what keeps me awake at night.  Somehow the pressure of my pillow against my head, neck and upper back makes the crawling feeling worse.  Often I sleep without a pillow for less surface area affected by the pressure.  Sometimes I end up laying on the floor instead.  A hard surface means an even smaller area of pressure.  Sometimes, I just don’t sleep.

Working with my neurologist, I started to receive botox injections into the muscles of my neck and upper back every three months in order to get the them to relax out of their constant state of contraction, known as dystonia.  The injection process makes me sweat.  My amazing and gentle neurologist apologizes as she inserts a probe into each of the muscles of my neck and upper back so that she can listen to the level of contraction on a machine.  Don’t ask me how this works, but it does.  Sometimes my dystonic muscles sound like thunderstorms.

The decibel level of my muscle storms helps my neurologist determine the amount of botox to inject.  During the three month interval between injections, the dystonia storms decrease for a time, and then increase again.  I do my best to maintain my physical inner stillness through yoga, chiropractic, meditation (the crawling sensations make this incredibly difficult), and massage.  All of these treatments help.  Together, they keep me sleeping just enough.

This past month, the appointment for my botox injections was canceled due to COVID-19, and since then my muscle storms have been extra loud.  I’ve been spending hours of my nights on the floor, and awake.  While I’m tired and uncomfortable, I count my blessings because my patients tell me stories that are much worse.

I’m working with a man who has severe back pain, to the point that he struggles to get out of bed, can’t function, and is desperately depressed.  His pathway to obtaining the surgery he needs to be able to function is blocked by COVID-19.  I’m worried about his ability to wait it out.

Another woman I work with has lupus, which is controlled via the medication hydroxychloriquine.  The scientifically unfounded assertions that this medicine can be used to treat COVID-19 have resulted in a shortage so severe that she can’t get her prescription filled for the chronic condition that it is actually intended for.  When she told me this, my mouth dropped open in consternation.  Untreated lupus has severe medical consequences.

The world is currently held in the clutches of an acute and life threatening virus, and I understand that my appointment for the botox injections that help me to live a more comfortable life were canceled to prevent exposure to both myself and my neurologist.  I’ll be OK.  However, I question the compassion of a world in which people take a life-sustaining medication away from someone who is uses it for its intended purpose, and redirects it based on dubious, non-medical assertions.

I also question a medical system that makes the cruel decision to keep a man in debilitating pain for months without treatment, relegating him to an existence of despair.  It seems to me that COVID-19 can be dealt with appropriately, and still create space for him to receive the help that he needs.  Our therapy appointments leave me feeling powerless, but I know my distress can’t even touch what he is going through.

My thoughts are with the people with chronic syndromes who are being left behind right now.  Please don’t lose hope.  I still see you, and I hope that in writing this piece others will see you too.  This situation can’t last forever, and I know that the hearts of the world, and the medical system, will re-open to you soon.  In the meantime, I suggest you try some online yoga classes, get outside for fresh air, do whatever you can to interact with your loved ones, and be gentle to yourself about the struggle we’re going through communally.  When in doubt, I always recommend increasing self care, because you deserve it.


An Interview with Heather Fenwick, Acupuncturist

In addition to this blog, I’ve been working on an “I’m Sick, Not Crazy” podcast, and I did my first podcast interview via Skype on this past Thursday with Heather Fenwick, who specializes in acupuncture and Chinese Medicine.  The interview was fascinating, and I thought that I would transcribe it so that I could share it in writing as well as video format.  After about 5 hours and 16 pages of transcription, I realized that was a mistake, and I decided to just share a few highlights here with you.  To view the entire interview, please check out my podcast, which is available on iTunes, YouTube or my website

First, I asked Heather to give an overview of how acupuncture works to facilitate healing in the body.  Here’s some of her answer:

Heather: Basically, the needles are inserted in a spot that has a little more conductivity to the brain.  There’s nothing in the needles.  So, it’s just a little signal that says to the brain, ‘Hey!  We need a little more help over here.’  There are certain times where there is too much stagnation we call it in Chinese Medicine.  A stuckness, or a tightness of a muscle is a stagnation, for example.  Often times a needle in that point will just say, ‘Hey, release the stagnation.  Things need to flow through here.’ Heather:

In other cases, we would call a deficiency, where there is not enough energy, not enough chi, not enough blood flow in Western Medical Terms.  A needle in that point would say, ‘Hey.  We need a little more neuron firing.  We need a little bit more circulation to this area.

And the brain figures it out.  The body is healing itself.  It’s crazy to wrap your head around everything that your brain can do.  The needles are just there to sort of tap the brain on the shoulder, and say, ‘Excuse me, Brain, we’re here.  We just need a little bit of help over here,’ and then the brain has infinite organizing power to just figure it out and fix it.  Your body fixes itself.

I love that Heather’s answer fits in with the purpose of my work, which is to help you learn how to take control of your own health and healing.  Using acupuncture, you can get your body’s energy flowing properly, so that you can heal yourself.  How marvelous!

When I asked her about cases that she’s worked on that illustrate how acupuncture can effect healing, she gave this example:

Heather: I’ve had a lot of people with physical pain in the body.  Low back pain that is debilitating, and now they can totally function.  I had one patient who had a pretty severe case of scoliosis, and she’d say ‘I ate ibuprofen.  I ate, like, nine ibuprofen yesterday.’  And then she just can’t even stand up.  So, she could just barely drive herself to the clinic. And I’gave her a treatment.  She left and she said, ‘I feel a little bit better, and then two days later she’s like, ‘I feel amazing.  I don’t know what you did, but I’m back to 100%.’

Every now and then I’ll have somebody who comes in and I’ll say, OK.  It’s going to take 4 to 6 treatments and then we’ll re-assess.  And every now and again, somebody’s like, ‘Oh yeah, the insomnia’s totally gone after one treatment.  I’m fine.  My anxiety level is perfect. I don’t wake up feeling foggy headed.’  So, every now and again, I’m surprised at how well and how quickly the medicine works, but it totally depends on the person and a case by case basis, but, yeah, those are the good moments, for sure.

Although it is the exception to the rule, it’s amazing to think that one treatment could make such a huge shift in someone’s health in some cases.  Even the more normal 4 to 6 sessions to reduce low back pain, which is extremely common and difficult to treat using Western Medicine, is a gift.

Then, I asked her a question I’ve always wondered as an acupuncture patient.  What is it that the acupuncturist learns from looking at my tongue?  The answer is fascinating.

Heather: So we look at the color of the tongue.  If it’s more purpley, that’s a stagnation.  Like a bruise, right?  A bruise is considered blood stagnation.  So purple will point toward blood stagnation.  Red is heat.  The tongue can be divided into anterior, middle and posterior, like front, middle and back thirds.  So, the front third is the upper part of the torso, heart and lung.  If it’s red, that points toward heart heat or lung heat.  The middle of the tongue is the stomach, the digestive organs.  While the sides of the tongue point towards liver and gallbladder.  The very back of the tongue points towards kidney and urinary bladder.  We look at the different parts of the tongue to show us these different organ systems.

The tongue is really cool because if you want to know what’s going on inside of the body, look at what’s coming out of the body.  And the tongue is both an internal and an external organ.

It had never occurred to me before, but she’s right.  The tongue is both internal and external at the same time.

For my next question, I asked her how she sees acupuncture fitting into a well-rounded healthcare regimen, and with Western Medicine.

Heather: Western Medicine can be very good for things that Chinese Medicine is just not good for.  If you break your arm and have a compound fracture where your bone is sticking out of your arm, then don’t come see me.

If you have stage 4 cancer, I can help with the effects of radiation and chemotherapy, but at that point, I think it’s best to go to the Western Medical model.  Obviously, I see some limitation in the Western Medicine model, in that they basically wait until it’s too late to try to treat something.  So, it’s always a band-aid kind of a treatment.

For the preventative side of it, obviously, the acupuncture is best.  If we’re doing preventative medicine at the onset, at the beginning of your low back pain, you start seeing an acupuncturist, and you start doing yoga, getting the corrective exercises, then 10 years down the road you’re not that candidate for low back pain.

I very much see them as integrated medicines.  Integrated, as in, they braid together.  The hospitals in China have acupuncture in the hospitals.  People who get chemotherapy get the chemotherapy in one arm, and Chinese herbs on the other arm. So, they can reduce their nausea and their low energy, and it’s very, very effective.  I would love to see Chinese herbs administered intravenously in the hospitals here, and we are gaining some traction for studies that they do and things that they can treat.

But there are certain things, like IBS, that a lot of people suffer from . . . Western Medicine is pretty clueless about what causes that. And, in Chinese Medicine, we have a theory for what causes it.  It’s liver overacting on spleen, and we know how to treat it very, very effectively.

This image of a chemotherapy patient receiving simultaneous infusions of chemo and Chinese herbs is so wonderful.  It gives me hope to think that these two very different types of treatment can be wedded together to create a more holistic and more effective approach to healing.  The knowledge that acupuncture is effective for IBS is extremely helpful as well.  I get a lot of IBS patients referred to psychotherapy because doctors feel that it is a psychological illness.  Unfortunately, treating IBS with psychotherapy hasn’t proven very effective, in my experience.  In the future, I’ll refer these patients to acupuncture.

After this, Heather and I discussed the importance of self-care, self-love, and seeing oneself as inherently worthy.  She told this wonderful story about the Dalai Lama:

Heather: There’s a story about the Dalai Lama. He had been coming to this science of mind meeting, with like, neuroscientists, or neurologists.  I don’t know.  Brains.  Really smart people, at like MIT.  They started to talk about self-esteem and how that leads to different issues, and he was, like, ‘Hey, can we time out for a second?’  And he went back and forth with a translator for a while about the concept of self-esteem because in the Tibetan language, and the Tibetan way of thinking, they don’t have a concept of self-esteem because every single life is a precious human life.  Every single one.

And so, you could see he was really confused, and he was like, ‘Well, how many—do lots of people suffer from low self-esteem?’ And they were like, ‘Yeah, yeah, yeah.  This is a thing.’  And he was like, ‘Well, how many people in this room suffer from low self-esteem?’ And, like, everybody raised their hand, and he was shocked.  The idea of having low self-esteem was shocking to him.  And he’s not conceited at all.  He’s the most humble human being on the planet.

It’s nice to take a step back and see the things that are just ingrained [like the concept of low self-esteem].  It’s like we’re swimming in this water, and then, hold on a second. What about this water?

If you would like more information about acupuncture and Chinese Medicine, Heather recommends the book The Web That Has No Weaver by Ted Kaptchuck.  She also, quite generously, offers herself as a resource.  She says that you can feel free to contact her at her website,, and send her a message through the link to request an appointment.

In Praise of Interdependence

For the past 3 weeks I’ve been working from home because of the COVID-19 quarantine situation.  For the first week, I was elated.  I slept late, worked in my yoga pants, and did little projects around the house between patient phone calls.  During the second week, I was less excited about it, but I was OK.  Then, the third week came, and the loneliness and isolation of three weeks by myself in my one-bedroom apartment hit me hard.  Like a caged tiger, I’ve been pacing around my living room, and peering through the black wrought iron of my security gate out into the quad outside my front door.

So, when my friend, Jeannine, contacted me yesterday and asked me to come over to her place for a social distancing dinner in her backyard, I was so excited I could barely contain myself.  When I got to her place, I had to swallow my need to hug both Jeannine and her husband, Paul.  Everything seemed hilarious.  When the chicken that Paul was barbecuing caught on fire and he couldn’t figure out how to rescue it, I laughed myself silly.  It didn’t matter to me that I might not have anything to eat.  I’d figure that out.  (The chicken ended up being perfectly cooked, by the way).  When we played Mexican Train, I felt nothing but joy and camaraderie, even though I lost miserably all three times.

It got me thinking about the value of community.  There’s a strange push-pull in American culture about needing others.  We definitely have a hero complex.  All you have to do is check out our film-making choices to see it.  How many incarnations of the strong and exceptional person saves the world alone are even possible?  I’ve grown to hate these hero movies.  They set up unrealistic expectations of self-reliance, fearlessness, and invulnerability.

On the other hand, American culture is one of the most extroverted cultures on earth.  Being highly social, overtly friendly, and always having something to say, are highly prized American personality traits.  As a Highly Sensitive Person, who needs alone time to re-charge, enjoys solo creative projects, and freezes around inauthentic people, I’ve felt defective for most of my life.  Telling myself that my need for solitude, my inability to come up with interesting things to say in large groups of people, and my lack of an emotional filter were weird, I’ve spent a lot of time pretending.  It’s only within the past year or so that I’ve realized that being wired this way is OK, and I’ve given myself permission to be my authentic self.  What a relief!

With pressure to be highly social and friendly, but also be a fearless lone savior, I think we’re all a little confused about how much community is the right amount.  I’m constantly struck by how many people tell me that they feel like they should be OK with being alone, and that the deep need that they feel to belong is wrong somehow.  They tell me that it’s a sign of codependence, and that they need to work on their unhealthy coping strategy of being with others to avoid feelings of loneliness.  Usually this comes up while the person is grieving the loss of a loved one.  Three weeks into grieving, people believe that they should be over it already.

This mindset never fails to sadden me.  What a sorry state of affairs to believe, as a society, that needing people is a sign of mental illness.   How terrible to think that grieving is somehow a weakness.  I explain to these people that codependence doesn’t mean what they think it means.  I tell them that codependence is actually a description of people that put their own needs aside in order to support others in an unhealthy and self destructive way.  I’m not talking about self-sacrifice for the greater good.  I’m talking about harming oneself because of an inability to set or respect boundaries.  Codependence is the person in a domestically violent relationship who doesn’t leave and makes excuses for the partner’s behavior.  It’s the spouse of the alcoholic who constantly cleans up horrible alcohol-induced messes, pays DUI fines, and apologizes to friends who have been subjected to drunken rages.

Needing love, community and support is completely normal and healthy.  We’ve evolved over millennia as tribal creatures.  Some of us need smaller tribes than others, but we all have a need to belong, to be understood, and to be loved, and that is a good thing.  Society would fall apart if humans didn’t naturally organize themselves into communal groups.  Where would we be if someone didn’t grow crops and share them with the rest of us?  What would happen if nobody cared for the sick, or educated our children?  It would be a much poorer life, indeed, if we weren’t the interdependent creatures that we are.

Interdependence is the exact opposite of codependence.  When we’re interdependent, we help, support, and care for the people around us, just as they help, support, and care for us in return.  Nobody is harmed in this reciprocal relationship, and everyone’s lives are enriched.  Interdependent relationships are a sign of mental and emotional health.  In order to have them, we have to be able to set the boundaries of what is OK and not OK in how we treat each other.  We also need to be able to respect those boundaries when they are set.  This type of relationship takes maturity, kindness, and compassion, and it is one of the most beautiful pieces of the great jigsaw puzzle of what makes us human.

One of my favorite things about the modern world is the web of global interdependence that allows me to buy goods from across the globe and have them in my home in a couple of days.  I love that I can tap into recordings that were made in Russia or India at the touch of a button, or that I can get on a plane and be in Italy in less than a day.  If I want to, I can buy a book written in another language, and then translated into my own, and absorb the ideas of another culture and another mind.  The more that we share ideas with each other, the more we understand each other, and the more that we see how much we are the same as humans no matter where we were born or which language we speak.

I know that my pacing loneliness is a result of a breakdown in interdependence.  I also know that toilet paper shortages, and the fact that I had to buy flour and yeast on, because I couldn’t find it anywhere else, in order to make the bread that is currently rising in my kitchen, is a result of a breakdown in interdependence.  I fear anything that threatens interdependence and understanding between humans, such as walls between nations, isolationism, or nationalism.

While I understand that sometimes we have to be alone to protect ourselves, to lick our wounds, and to heal, my hope is that these times of isolation are brief, and that we don’t end up as a world full of angsty teenagers hiding in their bedrooms playing video games with “keep out” signs on the door. When the danger of COVID-19 is passed, my hope for the world is that we will be brave enough to re-open to each other as a world full of humans who struggled together through something terrifying. I hope that we can be united in the knowledge that nobody is to blame for it because sometimes shitty things just happen because life is hard.  And yet, it is the hardest times that can hone us into the best humans if we are able to give the experience meaning.  May the meaning be love, kindness, compassion and community.

Below are some links for information about codependence and interdependence.  Two wonderful books about overcoming codependence are Codependent No More by Melody Beattie, and Facing Codependence by Pia Mellody.  Pia Mellody’s book was the first book I ever read about codependence, and it opened up a whole new way of thinking about healthy relationships for me.

Ten Articles About Codependence

How to Build a Relationship Built on Interdependence


Walking Through the Fires of Stress and Anxiety

We all have the thing that helps us when the world goes sideways.  For me, it’s sweets, especially chocolate.  It can be a serious problem for me.  It’s best just to avoid having chocolate in the house unless it’s the super dark chocolate that isn’t really sweet, and doesn’t bring on a need to eat the entire package in one sitting.  As negative coping skills go, this isn’t the worst.  It might lead to some weight gain and high blood sugar, but I can usually catch myself in an indulgence cycle fairly quickly and move myself toward the more self-supporting coping mechanisms that I have in place in my life, such as yoga, meditation, exercise,  and supportive friendships.

Some people aren’t so lucky, and their negative coping techniques are much more dangerous and self-destructive.  I’m talking about the drinking, the drugs, the self-mutilation, the toxic relationships, and any number of other terrible ways that people find to soothe themselves temporarily, while setting themselves up for failure in the long run.

Modern society is set up for instant gratification, and we’ve been conditioned to avoid things that are uncomfortable in favor of things that are pleasurable.  While we know that it might be better to make the effort to meal plan, grocery shop, and cook healthy dinners, it’s so much easier to go to the local take-out restaurant.  And while we know intellectually that the old relationship we left was toxic for us, and that we need to walk through the pain of a broken heart to get to a whole heart again, getting back together with that destructive person is so much easier.

People who have done their work understand that these negative coping techniques are the junk food of self care, and they take care to stock their emotional cupboards with more nourishing fare.  As long as life gives them the regular day to day stressors, they are able to cope in healthy ways. This is no small feat.  Life is difficult, even under the best of circumstances.

But right now, life isn’t normal.  While regular life is a field of hot coals for us to navigate in our bare feet, the healed understand that a fire walk is a spiritual test, and one can walk through unscathed by raising enough energy to match the fire.  However, these past few months, someone turned up the heat, and instead of coals, we have a fully fledged fire on our hands, and most of us don’t walk around in fire retardant gear.

Our skin is raw and scalded by loneliness, isolation, fear, anxiety, terrible news and political unrest.  In this climate, even those who usually can cope in a healthy manner, are turning to their more destructive coping skills.  I know that I have been eating much more chocolate than usual, and I even baked myself a batch of brownies a couple of days ago.  Now I’m in an apartment all by myself with a full batch of brownies.  This is a recipe for self-care disaster in my world.

Yet, others that I’ve talked to have been faring far worse.  Over the past week, I’ve spoken to a woman who relapsed after 12 years of sobriety, and another who cut herself after 15 years of recovery from self-mutilation, and yet another who is seriously considering getting back together with her abusive ex.  Regressions like these are sad enough on their own, but then add in the deep sense of failure and self-judgment that these people feel, and the likelihood of stopping the negative coping techniques anytime soon is quite small.

Going back to the metaphor of the fire, it is my belief that when life is at its worst, we have two choices, we can melt away, or we can forge ourselves into stronger steel.  The very worst moments in my life have led me to the most productive times of personal growth.  In psychological terms, this is known as sublimation, the process of using a terrible experience to create something beautiful.  We love stories of sublimation.  They help us to know that even the worst of experiences can be transformed into meaning.

For instance, I recently saw an interview with the musician, Jewel, where she discussed how she wrote her first hit song when she was homeless after losing her job because she refused to have sex with her boss.  That’s sublimation.  I’m currently in a sublimation cycle of my own through the book I’m writing, I’m Sick, Not Crazy, in order to share the story of my own debilitating illness, and subsequent healing through yoga.  My goal is to give others hope and to illuminate a path to wellness.

The difference between melting away in the fire, or forging yourself into stronger stuff through sublimation is two-fold.  First, reach for the self-sustaining coping skills when things go sideways.  Learn something new, talk with trusted friends and family, connect with the spiritual, journal, breathe, meditate, walk in nature, help others.

Second, when you succumb to the self-destructive, don’t beat yourself up about it and put yourself into a shame cycle that will keep you from getting back to the things that support you.  Instead, tell yourself that it’s OK and understandable that you slipped, and that it happens to the best of us sometimes.  This may sound counter-intuitive.  Many believe that by shaming themselves, they are motivating themselves to do better.  However, life and research prove this myth false.  Shaming oneself only leads to a downward spiral, and often to giving up completely.  Once you’ve told yourself it’s OK to make mistakes, which it always is, then make a choice to get back on your healthy path.

This sounds easy, but is quite difficult in practice.  Expect that you will mess up again.  When you do, tell yourself it’s OK, and go back to your healthy coping.  Do this again, and again, and again.  Mistakes are not failure.  They are learning in disguise.

Here are some links for information on coping skills that I think can be helpful to anyone.  I hope that you use them to support yourself is becoming stronger steel.

Grounding Skills

RAIN Mindfulness Technique

Self Compassion



Healing the Collective Trauma of COVID-19

The world is going through a collective trauma.  The first collective trauma in my lifetime was the Challenger explosion.  I remember sitting in my 5th grade classroom watching the news footage of the space shuttle exploding over and over and over.  It’s burned into my brain with complete precision, along with the details of the little classroom, and my desk and my teacher, Mr. Pike.

The second collective trauma of my lifetime was September 11th.  That morning, I was listening to music on my little clock radio while I got dressed to go to my Shakespeare class at San Diego State University, when the DJ announced the attack.  At first I didn’t believe it.  I thought someone was doing an Orson Welles, War of the Worlds, impression.  Every detail of my tiny bedroom in the first apartment that I ever rented on my own is perfectly recorded, including the black and white graphic printed bedspread and the framed Ikea print on the wall, and the words, “A plane has crashed into one of the Twin Towers.”  Perfect recall is often a symptom of trauma.

After the Challenger, the space program and NASA were never the same.  After September 11th, the whole world was different, including a war  and a death toll that still continues to rise.  More than that, the people were different; more suspicious, more on edge.  In psychological terms, this is known as hypervigilance, and it’s a common result of a trauma.  It means always looking over your shoulder to make sure you’re safe because you never know when the next attack might occur.  Since September 11th, the world, and especially the United States, have been perpetually looking over our collective shoulders, trying to identify and root out the threat before it strikes.  This is an extremely stressful state of being.

And just when we thought it might be safe to take a breath and rest, we find ourselves in a pandemic, with thousands sick, and thousands more losing their livelihoods overnight. The well are staying in their homes to shelter from an invisible enemy that kills, and in a time when comfort is the thing that we all need most, nobody is allowed to touch each other, let alone get within 6 feet of each other.  I, myself, am dying for a hug, and a whispered “It’s going to be OK.”  I know that I’m not alone.

Last weekend I went to the grocery store for supplies, and had to wait for an hour in a line that was two blocks long with marks taped onto the ground to help us to stay 6 feet apart.  A woman gave me a dirty look as I passed her to take my place in line, and I felt the fear and rage in her that I might be infected and get her sick.  Traumatized people often lash out without reason in an attempt to keep themselves safe.  Without a visible enemy, they often lash out at each other, somehow feeling safer as they push others away.  We’ve all seen the rage-a-holics in the world, angry with everyone as a way to protect their own deep and repressed wounds from growing any bigger.  It doesn’t work.  Wounds need tenderness to heal.

Yesterday I spoke with a friend in the nursing field, and she told me about the COVID-19 patients that she’s working with in a local hospital.  She told me that she saw a woman who had been unconscious wake up intubated and strapped down to keep her from pulling out her tubing.  My friend told me that the wild terror in the woman’s eyes brought her to tears.  I feel this story.  It hurts me deeply.  And I think that we’re all feeling it on one level or another.  We’ve all lost some agency over our own lives, and we’re all afraid.

In a traumatic world there is always ugliness, and we’ve seen our fair share of it already. There have been hate crimes against Asian Americans, and people hoarding supplies in extreme acts of selfishness.  However, there has also been beauty.  I just spent all day watching an online benefit concert with big name artists donating their time in order to raise money to help people that have lost their jobs due to COVID 19.  I’ve also seen stories of people buying groceries for those who can’t afford them.  I, myself, recently paid the difference when the woman ahead of me in line at the grocery store couldn’t afford her total bill.

My hope is that if you feel the desire to lash out, to hoard, or to protect yourself at the expense of others, that you remember that this is the trauma speaking.  It’s a natural defense mechanism of the animal brain, yes, but we are not animals.  We have the ability to choose our actions.  Take a breath and choose love, kindness and peace.  These are the qualities that bring healing to the traumatized.  These are the qualities that will allow us to heal ourselves.

The Value of Connection, and the Pain of Loneliness.

I want to talk about loneliness.  It’s my belief that this society is emotionally connection deprived, and starving for human touch.  I’m not talking about sex.  I’m talking about regular, everyday, things like hugs and pats on the back.  We have unlimited online connectivity.  I can talk to people in Japan, Russia, and Spain simultaneously, but an intimate conversation with someone close, and in person, is a rare and precious commodity.

In this world of screens and social media, people have the illusion of human connection, but they feel a deep ache of loneliness inside.  They try to fill up that hole with even more  screen time, online dating, Twitter, Tinder, Facebook, Snapchat, and then they wonder why the black hole of loneliness inside of them grows bigger every day.  They look at other people’s photos and profiles and wonder why everyone else seems to be happier and more connected than they are.  Intellectually they know that it’s not true, and that people are posting only their highlight reels.  They know that the outtakes are just as boring and sad as their own, but their nervous systems swirl inside with the pain of isolation.

In an effort to dull the pain, they get pets, which are wonderful–don’t get me wrong–but then the pets become pale substitutes for human affection and intimacy.  I’m constantly shocked by the number of people who tell me that the only reason they don’t kill themselves is because they need to be here to care for a cat or a dog–not a person.  Sometimes I think that instead of the diagnosis of depression that I’m putting in these people’s files, I should have the option of diagnosing loneliness.  We weren’t made to live this way.  We were built as tribal creatures, and we need people around us for support, connection, caring and love.

However, modern society has built a mythology of the lone wolf.  People have the idea that they are supposed to be able to make it on their own–that they shouldn’t need help, and that if they do, then there is something wrong with them.  As a result, people walk around pretending to have it all together, and they feel like frauds inside.  They believe that in being alone they have freedom, but they’re wrong.  True freedom is the freedom to be authentically oneself, not to be alone.  These people are in a prison of loneliness.

Then comes COVID-19, and just when I thought the world couldn’t get any lonelier, and people couldn’t get any more isolated, comes social distancing.  Most people have been laid off from work, are working from home, or are on furlough.  As a therapist for a major HMO, my job is considered essential, and I’m still going into work because they haven’t figured out how to send us to work from home.  However, all of my appointments are now by phone.  I can’t see my clients’ faces, feel their energy, or take in their body language.  My door is closed all day, and when I do leave my office, I have to wear a mask, which makes it so that I can’t even smile at my coworkers.  I can’t even breathe.  Then I go home to my apartment, where I live alone.

I’ve been joining some zoom meetings and having FaceTime with friends, and that helps some, but the truth is that I’m close to the loneliest I’ve ever been in my life, and I know that most of my friends feel the same way.  The ones that are in relationships are faring a little bit better, as long as they are good relationships.  The ones that are in bad relationships, are going through a serious test of whether they want to stay or not.

I understand the need for social distancing, and I’m not advocating that we go against the order and start infecting each other.  However, when this is over, I think we need to start valuing our connections much more than we have been.  We need to meet in person.  We need to commit to relationships when we meet someone good instead of thinking there must be someone better.  We need to have breakfast with friends, and lunch with coworkers.  We need to hug each other and tell each other that we love each other.

We need to remember that humans are tribal, and it isn’t weakness to need support or to want love.  We need to be willing to accept, as well as to give, help.  We need to remember that being alone is not freedom.  If you have someone in your life that you can be authentic with, know that you are blessed.  If you don’t, when this is over, make it your goal to find your people.

It is my professional opinion as a psychotherapist, that loneliness is a major factor in the development of mental illness, and that community can be a cure.  If you are depressed or anxious, I suggest that instead of following the urge to isolate, which is a symptom of these illnesses, you get close to others.  I run several therapeutic groups, and I believe that being with people who understand  and hear you is wonderful medicine, whether you’re sick or not.

How Yoga Saved My Life

With the COVID-19 crisis in full swing, it seems like the right time to talk about healing. I think we could all use more talk about health, and less talk about sickness. So, I thought that for my blog post today, I would talk about what started me on the road to wellness.

After the neck injury I described a couple of weeks ago, my condition deteriorated exponentially. Suffice it to say that I began to believe that I was going to die. For months I couldn’t keep any food down, my body was wracked with nausea, and I was exhausted in a way I’ve never experienced before or since. I intermittently had active tactile hallucinations, and nobody knew what exactly was wrong or how to help. Every test or intervention that the doctors tried only seemed to make things worse for me. It all seemed so hopeless that I formulated a plan to end my own life if things didn’t start to improve.

A coworker of mine who struggled with Crohn’s suggested that I visit her neurologist, Dr. Powell, and I was willing to try anything, so I managed to get approved by my insurance company for a second opinion appointment with him. He was a bit manic and unintelligible, but he made some extremely helpful suggestions.

“What stood out to me most was that he gave me something to do that would help me get well.  I needed to drink Gatorade, do yoga, and increase my Topamax to a therapeutic dose.  I could do all of those things.  While Dr. Huott had simply said that I might get better ‘with time,’ but there was nothing more they could do for me, Dr. Powell had given me tangible things I could do to get well.  He had given me hope” from I’m Sick, Not Crazy.

The value of hope and something actionable is without equal. Where other doctors had given me the message that I had zero agency in my own wellness, and that they were the only ones that had any power, Dr. Powell’s message was that I could take control of my own healing. By giving me something to do, he had done more for me than any of the other doctors or tests or procedures of the past year combined.

The next day, I began researching local yoga studios, and by the end of the week, I had a membership. I started with gentle yoga, which mostly consisted of candles and laying in different positions. After a few weeks, the exhaustion of the past year began to lessen. I worked my way up to yoga one, and the nausea abated to the point that I wasn’t taking anti-nausea medication 24 hours per day. By the time I was practicing level two, hot yoga, I was able to eat full meals again. Yoga saved my life.

Western Medicine doesn’t have all of the answers. It’s great for broken bones and antibiotics, but there are more things that doctors don’t know about healing than most people dare to believe. If your doctor has told you that there is nothing more to be done, please hear that as nothing more that Western Medicine can do, and look elsewhere. A combination of yoga, massage, acupuncture, and chiropractic worked for me, but there are many more options out there. Don’t believe that they can’t help. I’m living proof that they can.

Healthcare in the Time of COVID-19

Last night, for the first time ever, the tenants in my apartment complex all sat out in the quad together (6 feet of distance between them) to just chat because everyone is so lonely due to the COVID-19 social distancing rules. I was overjoyed to see this community building occurring. It is my hope that people continue to recognize the importance of human connection and communication, and just talk to each other.

The last few weeks have been strange and exhausting. There have been moments when my worst fears about the human race seem to be proven true, and moments when my heart just bursts with love and joy at seeing people helping each other get through this COVID-19 health and healthcare crisis. The videos coming from Italy of the communities singing together actually make my eyes well up with tears, they are so beautiful.

I work as a psychotherapist for a major HMO, and am considered essential personnel, so I am still going to work. Notices have been sent out hourly by management telling us about some new procedure we’re supposed to be following, and it’s been pretty much impossible to keep up. Mostly I’ve been talking to my patients by phone, and their responses to this crisis range from abject terror to a sense that it all is likely going to be over soon, and is probably blown out of proportion. Personally, I don’t know what the truth is.

Here is what I do know: the US Healthcare system is not set up for this. Since I work for an HMO, I can report from first hand experience that healthcare companies have been putting more and more pressure on healthcare workers for years. These companies have been shortening appointment times, and increasing the number of appointments that each provider has to complete per day. The psychiatrists where I work have 20 minutes to see a patient, and they have 3 of those appointments per hour, leaving no time for breaks or charting. I suspect the setup is similar for medical doctors. For therapists, we see a patient every hour on the hour. There isn’t any time in between for notes or bathroom breaks, so most of us limit appointments to 45 minutes in order to keep from getting too behind.

I don’t even get breaks. I work 5 days per week, and I only get 4 days per week where I have 1/2 an hour where I don’t have an appointment with a patient. During that time, I’m expected to do notes, return phone calls, and consult with my colleagues about shared cases. This is not nearly enough time for these tasks, so I work through my break almost every day, eating my lunch while I type case notes. Healthcare workers are exhausted, and they aren’t provided essential time to think about their cases, or research patient histories. Patients who don’t understand the situation that the healthcare workers are in due to their over-packed schedules are often frustrated and make the healthcare workers’ stress even worse by yelling at them for being late to appointments or not knowing their histories.

Healthcare providers don’t have time in their schedules for anything extra to happen. If a patient of mine is suicidal and needs hospitalization, the biggest problem for me to manage isn’t the emotional needs of my sick patient, it’s how I’m going to get them hospitalized before my next patient shows up. It’s not unheard of for me to be managing the hospitalization of one patient, while in session with another. The stress of trying to keep on top of my appointments added to the stress of dealing with a mental health crisis is exhausting, and I’ve seen more cases of psychotherapist burnout than I can count.

I’m not telling you this to try to get sympathy. The truth is that I love my work, and wouldn’t trade it for anything. I am telling you this because adding a pandemic to this already stressed system is a serious problem. Healthcare providers are already at their maximum capacity for patient care, and adding hundreds or thousands of sick people to an already unmanageable situation is too much for the system, and the workers, to bear.

Since I’m not just a healthcare worker, I’m also a healthcare consumer, I definitely know the frustration of waiting weeks for an appointment, only to find a frenzied healthcare provider who doesn’t have time to truly listen to what I have to say, and leaving without answers to my questions. This pressure on everyone’s schedules isn’t helping anyone, and I can’t imagine what is going to happen when COVID-19 shows up in force. I’m quite concerned that the system may collapse like a house of cards.

I don’t know what the solution is, but I urge you to be sensitive to what the healthcare workers are dealing with and only seek care if you absolutely must. If you find out that you’ve been exposed, and you aren’t sick, it will likely over-stress the system if you go in and try to get tested. If you do go in, recognize that you may need to wait to be seen, and remember that the healthcare workers are truly trying to do their best to help as many people as possible.

A pandemic is a situation unprecedented in my lifetime, and likely yours as well. It is my sincere hope that you and your family will remain healthy and whole throughout this crisis. Remember to take good care of yourself, not just physically, but also emotionally. Meditate, do yoga, take deep breaths, read things that nurture your spirit, and try to stay away from absorbing too much of the fear spread by the news media. I truly believe that we will get through this more quickly if we work together as a community.

How My Illness Began

Like the rest of my personality and life, my illness was outside of the proverbial box, and I had difficulty explaining what had happened to me when I was seeking help from medical professionals. Part of the difficulty was due to the cognitive effects of the injury that I sustained, and another part was due to the pure strangeness of the circumstance. Whenever I said that I had a whiplash injury, people would assume that I had been in a car accident. When I said that I’d sustained the injury while dancing, people would dismiss me as overreacting to a minor injury. I actually had several medical professionals laugh.

Since I’m writing this blog in support of the book I’m writing, I’m Sick, Not Crazy: How I Took Control of My Health When Western Medicine Told Me it Was All in My Head, I think it’s important that you understand the injury that kicked off my illness, so here’s the description from chapter one of my book (names have been changed to protect the not-so-innocent):

The night it happened, Michael, who organized the events, asked me to dance.  I was a little bit surprised.  My relationship with Michael had been awkward, for reasons that I didn’t fully understand, and for months he hadn’t asked to dance with me.  He was highly experienced, so he was fun and exciting to dance with, throwing in moves that I hadn’t been led into before.  Our dance started out fun and easy, and I relaxed into his practiced lead.  Then, to my complete surprise and chagrin, he grabbed my ribcage under my armpits with both his hands, and forcibly flung my upper body backward into a dip.  

As my spine curved as deeply as my body would allow, my head flung in an arc.  Having trusted Michael to lead me with respect, I wasn’t guarding myself, so my body was warm and pliable.  Mid-forced-dip, I did my best to flex my muscles and protect my body, but it was too late.  Michael abruptly pulled my body back up and out of the backbend.  Centrifugal force had its way, and my head continued backward as the rest of me was pulled upward, and my neck made a loud CRACK sound and stretched out from my shoulders like a slinky with a bowling ball stuck on the end.  Something at the base of my skull, on the left-hand side, seemed to become loose and squishy.  Wow, I thought, that felt really weird.  After what seemed like forever, my head caught back up with my body and I stood upright in front Michael, dazed.  

He grinned and said, “I know you like it rough like that.” 


I frowned at him.  He didn’t seem to notice my distress at all, and just kept leading with a self-satisfied look on his face.  Shocked into silence, I unenthusiastically kept following his lead, waiting for the song to end so I could get away without a public confrontation.  When the song ended, and Michael let me go, I was relieved.  I sat down, shaken; taking stock of my body. Rolling my neck from side to side, checking the range of motion, and moving my limbs around told me that my neck wasn’t broken.  I told myself that meant I was OK, and I got up and got back into the dance.

            In the morning, concerned for my own wellbeing after the dipping incident of the night before, I went to Urgent Care.  The doctor took X-Rays and told me that everything looked fine.  No lasting damage.  Relieved that it wasn’t more serious, I resolved not to dance with Michael anymore, and mentally planned to get back into my regular routine. 

That night, I woke up a few hours after falling asleep and vomited until the sun came up.  Over the next few weeks, things steadily got worse.  There were days where I felt mostly normal, and days when I felt like I had been filled with poison and couldn’t see or think straight, and the worst was the nights spent on the bathroom floor vomiting into the toilet.  Never having sustained an injury that didn’t readily heal before, I thought that if I waited it out, I would start to feel better.  

            With the attitude that this was all quite temporary, but that I should get looked at anyway, I decided to go and see my own primary care physician, Dr. Benavides, and explained to her the injury that I had sustained and how I was having so many problems afterward.  I felt certain that she would know what to do.  All of my experience of the medical system before this had shown that they would be able to help me when things got rough.  

When I had pneumonia and was so weak that I couldn’t make a fist, there were antibiotics.  When I had labyrinthitis and was so dizzy that I had to crawl back and forth from bed to the bathroom until it cleared up, the doctors had known what it was and what to do.  I had even been hospitalized a couple of times, but the doctors had been able to diagnose and treat my symptoms effectively.  In my mind, I wouldn’t be alive if it weren’t for Western medicine. 

            Dr. Benavides listened to my story and then had me put my arms out straight ahead of me and resist her while she pushed down.  She said that it seemed that my body was stable, and she wanted me to engage in physical therapy.  She made the referral and I started seeing David, a physical therapist, a couple of times per week.  He was tall and thin, with the coolest hands I’ve ever encountered, which felt delicious when he worked on my neck.  The poor man spent an inordinate amount of time working in my armpit, and he kept telling me to place my hands on either side of open doorways and then stretch my arms open against them to open up my chest.  He said, “I don’t think you could do too much of that.”  I did the exercises he prescribed religiously, but things only got worse.            

My buttocks were extremely sore for several weeks, to the point that I had to buy a cushion for my seat at work and sitting down after standing was so painful that it I groaned.  I started to have a sensation of strangling across the front of my neck.  It felt like I was slowly being garroted all of the time, and sometimes I felt I could hardly breathe.  There was numbness and tingling in my forearms and pins and needles in the back of my neck.  My head felt unstable on my neck like my muscles were suddenly too weak to hold it up.  I was frightened.

From I’m Sick, Not Crazy by Jennifer James

Things only deteriorated from there. It’s still not clear exactly what happened inside of my body, although I have some theories. Diagnoses ranged from brain cancer to occipital neuralgia to multiple sclerosis as I went through multiple medical tests to try to find out what was wrong with me and how to treat the problem. The testing process was traumatic, and didn’t ever give a definitive diagnosis. Eventually, I had to accept that my body was never going to be quite the same, and start looking for ways to minimize the impact of the injury on my life, and maximize my ability to live.

As it turned out, Western Medicine didn’t have the answers I needed, and it wasn’t until an inspired neurologist suggested that I start practicing yoga that I actually began to heal. My book describes the descent into illness, and how I managed to pull myself out of the hole through alternative treatments. I believe that those of us with outside of the box illnesses don’t have to rely on a medical system that doesn’t know what to do with us, and often blames us for what we are going through. We can take control of our own healing and move toward wellness through multiple avenues. It can take some trial and error to find what works for you, but I encourage you to explore, and yoga is a great place to start, especially for physical injuries.