See the Stars

When it gets dark enough, you can see the stars.

Charles A. Beard

It may come as a surprise to few that many people present for therapy during the darkest of times.  New patients may feel powerless to change their circumstances, hopeless to overcome their problems.  We clinicians like to point out that, through therapy, people often gain the tools necessary to first cope and then to feel stronger, maybe stronger than ever, and then ultimately to overcome the difficult obstacles they face.   


It can help to believe that dark points in our lives may be fulcrum moments, the very point at which we gain the help we need to make substantial life changes.  To find the power within ourselves to take action and change.   

It would be foolish to suggest that we should look forward to low moods and hardship.  But it is worthy to suggest that when they arrive we can learn to accept them  as temporary turning points.  Maybe even necessary turning points.  To embrace the potential adversity presents.  As an end to stagnation.  The pivotal shift we need to grow.   Stronger.  To learn. To succeed.  To  flourish. 

As this quote suggests, we can learn to look beyond the clouds.  Look into that darkness.  Look for the stars.  We might just find incredible, life fulfilling opportunity.  

Your Brain on Sleep

Seems we cannot talk enough during therapy sessions about the importance of getting the right amount of quality sleep.  So much research is pointing toward the role of sleep deprivation in mental health problems are surfacing.  And more and more we are becoming a sleep deprived nation.

Many factors interfere with getting a quality night of sleep such as anxiety/worry/stress, alcohol and caffeine use, medications with stimulating side effects (for example, decongestants and ADHD stimulants such as Ritalin), and late night activities including video game playing, internet surfing, and television viewing.

 When I saw this excellent graphic on the OnlineCollege website, I decided to post it here.  A lot of information packed into one colorful visual can be a helpful tool.  And especially appreciated when someone else put the work into it.  So thank you OnlineCollege.  You may want to enlarge the graphic - on my PC I click Ctrl +

Feeling Low? Make a Pleasant Events List

In honor of the New Year and good intentions to make improvements in our lives, I am re-posting a revised Pleasant Events List.  Those of you who read the previous post will be glad to see I've made a few changes, out with some of the old and in with some new ideas.

For those reading this list for the first time, what is it all about?

When someone is experiencing a sad, down, angry, lonely, or otherwise lowered mood, one tip that can help is to consult your own personal Pleasant Events List.

Below is a lonnnnnng list of Pleasant Events. It was compiled from a variety of sources, some of which I no longer recall. But I do remember a co-therapist telling me she gathered lists generated by clients in a former therapy group she ran. I kept most of the list intact, even when I was puzzled by the content. Different people find different activities uplifting (cleaning the bathroom, being one that I find a real stretch, but... different strokes).

The list is meant as a starting point: A list of ideas that will help you generate a list of your own. So that you can write your own personalized list of activities and thoughts you find pleasant, fun, funny, joyful, entertaining, relaxing, soothing, or in some other way, mood-lifting.

So I post this list in the hopes that readers will be inspired to read it, to do some of the things on the list, or to merely think about doing some of the things on the list, to leave a comment with some new pleasant event that can be added to the list, or to generate a new list of your own. Best of all, generate your list with as many readily do-able, easily accessable, easily affordable events as you can come up with.

As one exercise, I often suggest before reading the list that you rate your mood on a scale of 1 to 10, where:

1 = feeling very down or "low"

and

10 = feeling really happy or "up"

Then, after you have finished reading the list, rate how you feel once again. Any change?

PLEASANT EVENTS LIST

1. Soaking in the bathtub   

2. Looking at the stars       

3. Feeling the wind in my hair

4. Collecting things (coins, shells, etc)

5. Listening to fun, educational programming, such as TED or NPR podcasts

6. Thinking how it will be when I finish school

7. Working a crossword or sudoku puzzle

8. Trying out a new hair style

9. Sitting under a shade tree

10. Going to a movie in the middle of the week

11. Taking a walk around the block or even to the mailbox

12. Thinking about how I have done a full day's work

13. Watching or renting a favorite old movie

14. Recalling past parties

15.  Surfing the internet

16. Lying in the sun

17. Planning a career change

18. Rearranging furniture in a room or a bookshelf or a cabinet

19. Thinking about or looking at pictures of my past trips and vacations 

20. Listening to others tell happy stories

21. Reading magazines I've got sitting around  

22. Hobbies (stamp collecting, model building, etc.)

23. Spending time with good friends

24. Planning my next day off

25. Hunting around for beautiful images on the web:  flickr or photobucket, etc

26. Looking for pictures in magazines, books or on the internet of places I'd like to visit

27. Thinking of ways to meet new people

28. Looking at clouds and imagining different shapes

29.  Re-potting a plant

30. Eating my favorite dessert

31. Practicing karate, judo, yoga

32. Thinking what I will do when I retire, writing a "bucket list"

33. Repairing things around the house

34. Working on my car (bicycle, motorcycle)

35. Remembering the words and deeds of loving people

36. Looking at artists' paintings and works online, such as Olga's Gallery or Artspan

37. Writing a hand-written note, letter or thank you card 

38. Taking care of my plants    

39. Plan a healthy meal, make a salad 

40. Going swimming

41. Doodling

42. Exercising, watching an excercise video, jogging in place, or jumping rope

43.  Phoning up a friend and asking them to tell you a joke

44. Going to a party

45. Learning something new on video, like how to make a the best paper airplane.

46. Playing golf, hitting practice balls

47. Playing soccer

48. Flying kites

49. Having discussions with friends

50. Planning family get-togethers

51. Riding a motorbike or scooter

52. Having sex with the person I love or with myself

53. Hugging a tree, yes literally hugging a tree

54. Going camping  

55. Singing around the house

56. Arranging flowers

57. Practicing religion (go to church, praying, etc)

58. Going to an art gallery

59. Going to the beach

60. Thinking of the many ways I'm an OK person

61. Thinking how I would spend a day with nothing to do

62. Looking into class reunions

63. Going skating

64. Walking in a field and looking for different wildflowers or birds  

65.  Exploring local clubs or groups, by reading the paper or looking online (i.e., MeetUp )

66. Painting, drawing, watercolor

67. Doing something spontaneously

68. Go to a local nature or botanical garden.  Ladybird's Wildflower Center free the month of January!

69. Sleeping, taking a nap

70. Taking a drive in the country

71. Planning the next time I'll entertain, making calls to invite people 

72. Going to clubs (garden, support groups)

73. Thinking about getting married

74. Going hunting

75. Singing with groups or karaoke

76. Flirting    

77. Playing musical instruments

78. Doing hobbies, arts and crafts   

79. Making a gift for someone

80. Buying CDs

81. Watching boxing or wrestling

82. Window shopping on such sites as Craigslist or Ebay or Etsy (handmade items)

83. Cooking something special

84. Going hiking

85. Writing poems, personal journals, articles or essays

86. Sewing or mending something

87. Light a scented candle and watch the flame flicker

88. Going out to dinner

89. Scrapbooking

90. Discussing books, joining or looking for a book club

91. Taking a walk in tourist areas of my city

92. Gardening

93. Getting my hair done

94. Early morning coffee and newspaper

95. Taking up some new, interesting form of exercise (but going easy) 

96. Kissing

97. Watching children play

98. Thinking I have a lot more going for me than most

99. Going to plays and concerts

100. Daydreaming

101. Exploring ideas for a new hobby or interest at educational center such as UT Informal Classes

102. Stretching my muscles

103.  Making a collage, book making,  therapeutic collage using magazine cut outs

104. Listening to a stereo

105. Refinishing furniture

107. Making a to do list. Choosing one that takes 15 minutes and deciding to do it 

108. Going bike riding

109. Walking in the woods, in a park, or along a waterfront

110. Buying gifts for someone special

111. Thinking about what national or state parks I want to visit

112. Completing a 15-minute task I've been putting off

113. Collecting shells

114. Going to a spectator sport

115. Eating my favorite comfort food 

116. Teaching, planning a new lesson

117. Photography

118. Going fishing

119. Exploring new hiking trails   

120. Thrift shopping

121. Playing with my pets or a neighbor's pets

122. Looking up volunteer opportunities

123. Re-reading a favorite novel 

124. Pursuing acting in local theatre or helping with production

125. Being alone

126. Writing diary entries or letters

127. Organizing one drawer that needs it

128. Reading a self-help book or magazine article

129. Taking children to fun places

130. Dancing 

131. Going on a picnic

132. Listening to online radio, such as Pandora or KUT

133. Meditating, visualizing my special place

134.  Playing basketball, shooting baskets

135.  Having lunch with a friend

136. Reading blogs (like you are doing now), starting or writing a blog

137. Thinking about having a family

138. Writing a list of my Top Ten Happiest Moments

139. Splurging on a fun treat, such as a fruit smoothie or snow cone

140. Playing cards, solitaire

141. Going to garage sales

142. Having a political discussion, following political blogs

143. Signing up and playing softball

144. Seeing and/or showing photos or slides

145. Playing guitar or other musical instrument

146. Knitting or crochet or cross stitch or other hand work

147. Doing crossword puzzles   

148. Shooting pool

149. Reading the newspaper

150. Reflecting on how I've improved

151. Playing online video games such as Pogo or Yahoo games

152. Talking on the phone

153. Going to museums

154. Thinking religious thoughts

155. Going to a sports bar to catch a game

156. Listening to the radio or stereo

157. Sending an email to someone I've lost touch with

158. Saying "I love you" to someone I love

159. Making bead jewelry  

160. Buying or trading books

161. Taking a sauna or steam bath

162. Holding hands with someone I care about

163. Spending time at the library

164. Canoeing

165. Throwing a frisbee

166. Doing woodworking

167. Fantasizing about the future

168. Practicing ballet or tap dancing

169. Taking a drive on a pretty road or in a unique neighborhood

168. Taking my dog for a walk  or offering to walk a neighbor's dog

169. Sitting in a sidewalk cafe   

170. Having an aquarium

171. Painting my nails

172. Going horseback riding

173. Thinking about becoming active in the community

174. Doing something new and challenging

175. Completing jigsaw puzzles

176. Thinking I'm a person who can cope

177. Giving myself a pedicure

178. Thinking about the last time I laughed so hard my face hurt 

179. Taking a hot shower

180. Lying in bed listening to the rain outside

181. Making a long distance phone call

182. Taking a bubble bath

183. Browsing a book store

184. Thinking of someone I could have a good conversation with

185. Going to the beach

186. Finding a $20 bill in your coat from last winter

187. Laughing at yourself

188. Midnight phone calls that last for hours

189. Running through sprinklers

190. Reading blogs (like you are doing now), starting or writing a blog

191. Writing a list of my strengths, what I have to offer a friend or partner

192.  Relaxing in a hot tub

193.  Playing tennis, hitting balls against a backboard

194.  Watching the sunrise or sunset

195. Waking up and realizing you still have a few hours left to sleep

196. Thinking about a first kiss (my very first or with a new partner)

197.  Playing pingpong

198. Visiting a local animal shelter or humane society.  Better yet, volunteer.  

199. Letting a child or grandchild play with my hair    

200.  Hula hooping

201. Making myself a hot chocolate or cup of herbal tea

202. Thinking about a road trip with friends, a previous one or one I'd like to take

203. Swinging on a swing 

204. Drinking a glass of ice water with lemon

205. Reading song lyrics printed inside your new CD so you can sing along

206. Going to a music concert

207. Eating chocolate chip cookies, fresh out of the oven

208. Winning a really competitive game

209.  Reader? Can you add a pleasant event?

210. Looking at old pictures or home movies

211.  Turning off and tuning in to myself and being one with source

212. Taking a moon bath

213.  Using tarot cards

214.  Surfing in the ocean

215. Reader? Can you add a pleasant event?  Or spot check and let me know if my list repeats?

Vulnerability and Worthiness

If you have a little bit of time over the busy holiday season, have a seat and listen to this powerful message.  Or, if you are like me, have a stand and listen as you bake or wrap presents or chop vegetables.  It's a timely message since holidays often represent spending extended time with extended family. It's also a great way to become familiar with some of the more personal, fascinating, and relevant types of research.

Keeping a Sleep Diary

Depression and anxiety go hand in hand with sleep problems.  By no means a hard and fast rule, its common to find that people with an anxiety disorders have trouble falling asleep while people struggling with depression have trouble staying asleep.  The reverse trend is seen also or some blend of both.

What comes first, the chicken or the egg?  Do persistent sleep difficulties cause depression and anxiety?  Or does the disorder come first causing insomnia?  I have seen what appears to be both cases.  Sometimes a very stressful life event occurs (death of a loved one, birth of a child) and sleep disorders present as a result.  Other times a patient will present with a history of poor sleep that has persisted so long that panic disorder is now seen by day.  

No matter the origin, targeting more hours and better quality sleep is a typical treatment goal in cognitive behavioral therapy.  Changing one's sleep routine is a great example of a behavioral goal.  Eliminating caffeine is another.  Cognitive goals include meditation, visualization exercises, and thought replacement.  

Here's an example of a typical thought that teaches your brain to stay awake:  


What time is it?  I'll never get enough sleep! 


But you can help ease your mind into restful sleep by changing that thought to, 


I can calm my mind and think about a beautiful sunset.  

or,


I am thinking of all the things I am grateful for.  I am grateful for ... and start a list while deep breathing (another behavioral technique).  

Regardless of your sleep troubles, keeping a Sleep Diary is a great way to show your doctor or therapist exactly what your patterns of sleep (and non-sleep) are.  Here is a list of various sleep aspects we professionals like to assess:  

1) Time you went to bed and woke up;

2) Total sleep hours;

3) Quality of sleep (e.g., soundly, restless, exhausted in the morning);

4) Times that you were awake during the night and what you did (e.g. stayed in bed with eyes closed or got up, had a glass of milk and meditated);

5) Amount of caffeine or alcohol you consumed and times of consumption;

6) Types of food and drink and times of consumption;

7) Feelings - happiness, sadness, stress, anxiety;

8) Drugs or medications taken, amount and times taken;

9) Stressful events and particular worry thoughts ongoing, that day or pre-bedtime. 

You can copy or download an example of a sleep diary, here or here.   

In addition to keeping a sleep diary you can review this list of tips for improving your sleep.  Look to see which of the helpful sleep habits are part of your routine and which are habits you routinely break or have never practiced.  These steps are a way to use your time while you search for a qualified psychologist, sleep expert or physician and help your doctor help you toward finding sleep solutions.  

Insomnia painting by Micheal Lemus Fletchall, here.  

Say No To Drugs - What Helps for Depression

It is more and more common for clients to tell me they want to work on their mental health symptoms without the use of medications, especially in light of recent findings questioning the efficacy of several commonly prescribed antidepressants.  I like to support the goal of avoiding psychotropic medications in some situations.  While it is true that some disorders require medication (bipolar disorder, schizophrenia, as two examples), especially those where the symptoms have reached severe levels (persistent suicidal thoughts or intent), it is often a welcome sign that a person is interested in doing all they can, on their own, to feel better. 

So when I read this review on PsychCentral, written by Therese Borchard, I wanted to share a summary here for those of you who want to know what are some of the most effective ways to manage your depression without medication.  Although, I want to add, these are excellent suggestions for people taking medications as well.

Six Steps for Beating Depression

From 
“The Depression Cure: 6-Step Program to Beat Depression without Drugs,”

by Stephen Ilardi

1. Omega-3 Fatty Acids   Seafood, oils (flaxseed oil -unheated; canola or soybean oil for cooking), beans (kidney, pinto, mungo), nuts, seeds, spinach, winter squash, broccoli, cauliflower, dietary supplements (fish oil, flaxseed oil).



2. Engaged Activity  keeps us from ruminating, and ruminating causes depression.
Socializing, reading, hobbies, creating art, exercise of all kinds.

3. Physical Exercise    Research suggests 30 minutes  of brisk walking three times a week can be as effective as some medications AND exercisers are less likely to become depressed again later.    Activities such as walking, biking, jogging, and weight lifting.  Exercise changes the brain. It increases the activity level of important brain chemicals such as dopamine and serotonin and a key growth hormone called BDNF. Because levels of this hormone plummet in depression, some parts of the brain start to shrink over time, and learning and memory are impaired. But exercise reverses this trend, protecting the brain in a way nothing else can.


4. Sunlight Exposure Important for keeping the body’s internal clock working properly. Without light exposure, the body clock gets out of sync, throwing off important circadian rhythms that regulate energy, sleep, appetite, and hormone levels. On average – a half hour of sunlight is enough to reset your body clock, even on gray, cloudy days.


5. Social Support   Relationships matter. The more satisfying the connections, the better. Think about ways to increase the number of people in your social network especially those you can confide in.


6. Sleep    Disrupted sleep is one of the most potent triggers of depression, and there’s evidence that most episodes of mood disorder are preceded by at least several weeks of subpar slumber.   Keep a sleep log.  Each morning write the estimated number of hours you slept the night before to include approximately how many times you woke up throughout the night and couldn’t get back to sleep for more than ~ten minutes.  

Recovery Inc: A Cognitive Tools Support Group

This a repost from two years ago.  I continue to believe in the potential effectiveness of this support group for people experiencing anxiety, depression and other disorders.

There's a little known but excellent support group resource available here in Austin, Texas and in hundreds of cities nationwide. It's called Recovery, Inc. It also goes by Recovery International.

The names are misleading which may explain the relative obscurity of the support group. Recovery is now a term that most people, including myself, associate with substance abuse recovery. But Recovery, Inc. is a self-help support group designed to assist people struggling with anxiety and depression. It can also help people with a variety of different psychological and emotional difficulties. For a list of the many struggles Recovery, Inc. can offer assistance with, click here. People who have alcohol and drug abuse issues can be helped, too, so long as their substance abuse is under control.

I assume the name confusion is why Recovery, Inc. has been undergoing some name changes. Their website tells me it is now being referred to as the Abraham Low Self Help Systems after the group's original creator, Abraham Low, M.D. You can read more, here.

But the name isn't so important. What matters is the group's core focus: teaching and helping group members persistently use cognitive skills to reduce symptoms.

I've had a few patients attend these groups. I have been consistently impressed with the quality of the skills taught there. I often refer my clients to the group in the hopes they will use it as a place to practice the cognitive skills learned in my individual therapy sessions, learn new skills above and beyond what our sessions have covered, and gain social support. I also refer individuals who are not attending therapy but would like some free-of-charge group support.

Recovery, Inc. teaches tools to help people cope better with situations that provoke unpleasant feelings and emotions. They call these tools "Recovery Language."

One typical example: Many people experience significant anxiety walking into a support group for the very first time. Anxiety that, for so many, is anticipated ahead of time to such an extent that they fail to go to the group at all. Typical thoughts are, "I won't know anyone and I'll feel stupid." "I won't know what to say." "I'll be too nervous to talk and then I'll look ridiculous." "What if I walk into the room and everyone stares at me?"

The anxiety, fed by these negative, fear inducing thoughts, can mount until one feels overwhelmed and stays home, or stays in the car and drives away.
Recovery language might encourage you to "spot" and replace these negative thoughts with more realistic and empowering ones, such as:

"These thoughts are distressing, not dangerous."

"It is perfectly average for someone to feel nervous when walking into a new group."

"I can do this. I am capable."

"I will move my muscles and start heading inside."

"Bear the discomfort and comfort will come."

For more examples of personal situations, use this link to get to the in the self-help forums.

I've had a few patients attend only one meeting. Their complaint was that they didn't quite "get it." As I understand the group format, members use Recovery Language and new people feel a bit lost and confused. My advice to patients is this: Plan to attend at least three groups. See if some of the initial confusion, which again is average (a recovery term) lessens over time. See if you don't start to feel a little more comfortable. Find out how you can learn the Recovery Language for yourself. You will likely be encouraged to buy a book but it isn't essential.

So take the first step. Move your muscles to use the following link to find the support group closest to you.

I would love to hear readers first hand experience with Recovery, Inc. so feel free to share in the comment section.

You Are Here To Risk Your Heart

Life will break you. Nobody can protect you from that, and living alone won't either, for solitude will also break you with its yearning. You have to love. You have to feel. It is the reason you are here on earth. You are here to risk your heart. You are here to be swallowed up. And when it happens that you are broken, or betrayed, or left, or hurt, or death brushes near, let yourself sit by an apple tree and listen to the apples falling all around you in heaps, wasting their sweetness. Tell yourself you tasted as many as you could.

—
Louise Erdrich
from The Painted Drum

On Relieving Stress

     We hear so much about stress these days:  The effects of stress on our bodies - high blood pressure, headaches - and on our mental state - increased substance abuse, anger outbursts, depression.

    Stress management is frequently taught in Cognitive Behavioral Therapy (CBT).  A series of tools that help teach us to lower the negative effects of stress, to help us cope with the stress we face in our daily lives, to help us return to physical and psychological health.

One tool I frequently recommend is deep breathing.  Daily practice in taking deeper breaths: fuller inhales and emptying exhales.  You can click on this link to read about ways to improve your breathing patterns.  

Below is a discussion on different kinds of stress, physical and psychological problems related to stress and a list of suggestions to help cope.  These were found on the website of the American Psychological Association.

More Tips for Coping with Stress

By AMERICAN PSYCHOLOGICAL ASSOCIATION

Most people have felt stress at one point in their lives. Sometimes it’s brief and highly situational, like being in heavy traffic. Other times, it’s more persistent and complex — relationship problems, an ailing family member, a spouse’s death. And sometimes, stress can motivate us to accomplish certain tasks.

Dangerous Stress

Stress becomes dangerous when it interferes with your ability to live a normal life for an extended period of time. You may feel “out of control” and have no idea of what to do, even if the cause is relatively minor. This in turn, may cause you to feel continually fatigued, unable to concentrate, or irritable in otherwise relaxed situations. Prolonged stress may also compound any emotional problems stemming from sudden events such traumatic experiences in your past, and increase thoughts of suicide.

Natural reactions to stress

Stress can also affect your physical health because of the human body’s built-in response mechanisms. You may have found yourself sweating at the thought of an important date, or felt your heartbeat pick up while watching a scary movie. These reactions are caused by hormones that scientists believe helped our ancestors cope with the threats and uncertainties of their world.
If the cause of your stress is temporary, the physical effects are usually short-term as well. In one study, the pressure of taking exams led to increased severity of acne among college students, regardless of how they ate or slept. The condition diminished after exams were over. Abdominal pain and irregularity have also been linked to situational stress.

The longer your mind feels stressed, however, the longer your physical reaction systems remain activated. This can lead to more serious health issues.

Physical wear and tear of stress

The old saying that stress “ages” a person faster than normal was recently verified in a study of women who had spent many years caring for severely ill and disabled children. Because their bodies were no longer able to fully regenerate blood cells, these women were found to be physically a decade older than their chronological age.

Extended reactions to stress can alter the body’s immune system in ways that are associated with other “aging” conditions such as frailty, functional decline, cardiovascular disease, osteoporosis, inflammatory arthritis, type 2 diabetes, and certain cancers.

Research also suggests that stress impairs the brain’s ability to block certain toxins and other large, potentially harmful molecules. This condition is also common to patients suffering from Alzheimer’s Disease.

Pressure points

Although sudden emotional stress has been linked to severe heart dysfunction in otherwise healthy people, scientists are uncertain whether chronic stress alone causes cardiovascular disease. What is clear is that excessive stress can worsen existing risk factors such as hypertension and high cholesterol levels. Studies also show that people who are quick to anger or who display frequent hostility—a behavior common to those under stress—have an increased risk of heart disease and crying fits.

Feelings of despair that accompany stress can easily worsen into chronic depression, a condition that can lead you to neglect good diet and activity habits. This, in turn, can put you at a greater risk for heart disease, obesity, and kidney dysfunction.

Stress can also complicate your ability to recover from a serious illness or nap. A Swedish study found that women who have suffered heart attacks tend to have poorer chances of recovery if they are also experiencing marital stressors such as infidelity, alcohol abuse, and a spouse’s physical or psychiatric illness. On the other hand, stress management training is a proven method for helping speed recovery follow a heart attack.

What you can do to help reduce stress

Learning to deal with stress effectively is a worthwhile effort, even if you already consider yourself capable of handling anything life sends your way.

Many of the most common long-term stressors — family illness, recovery after injury, career pressures—often arise without warning and simultaneously. Stress management is particularly valuable if your family has a history of hypertension and other forms of heart disease.

Identify the cause.
You may find that your stress arises from something that’s easy to correct. A psychologist can help you define and analyze these stressors, and develop action plans for dealing with them.

Monitor your moods.
If you feel stressed during the day, write down what caused it along your thoughts and moods. Again, you may find the cause to be less serious than you first thought.

Make time for yourself at least two or three times a week. 
Even ten minutes a day of “personal time” can help refresh your mental outlook and slow down your body’s stress response systems. Turn off the phone, spend time alone in your room, exercise, or meditate to your favorite music.

Walk away when you’re angry.
Before you react, take time to mentally regroup by counting to 10. Then look at the situation again. Walking or other physical activities will also help you work off steam.

Analyze your schedule.
Assess your priorities and delegate whatever tasks you can (e.g., order out dinner after a busy day, share household responsibilities). Eliminate tasks that are “shoulds” but not “musts.”

Set reasonable standards for yourself and others. 
Don’t expect perfection.

Couples Communication: Assertiveness with Empathy

Sheep Herd Tapestry 

by Barbara Levitux

The conception of two people living together for twenty-five years 

without having a cross word suggests a lack of spirit 

only to be admired in sheep.  

-Alan Patrick Herbert, English writer and Member of Parliament

Most all of us understand that constant bickering, arguing, and loud shouting matches are not healthy for relationships.  But what too few people understand is that the opposite is not healthy either.  Any longtime partnership, be it love or work, will involve conflict.  And conflict necessitates talking it out.

John Gottman, PhD and his research team have found* that couples who seldom argue, conflict avoiders as he calls them, are at high risk to break up.

Couples therapy almost always involves learning and practicing assertive communication skills.  In my couples work and individual therapy I encourage assertiveness with empathy as one form of resolving conflict.

This will probably take you by surprise but I don't like going to the same restaurants all the time. I know they are your favorites but I'd like to try something new. What do you think? 

Text in red denotes statements of empathy or showing that you understand and care about the other person's viewpoint.

Using empathic statements helps make assertiveness more successful.  Helps the partner you are communicating with feel heard, more at ease, understood, rather than attacked. Helps the partner be more open to your suggestions.

I know you like for me to do the laundry but I want to change things up.  I want do my own and you do your own from now on. I've gotten busier at work and don't have as much free time as I used to.  You may not know how, but I can show you this weekend if you'd like.

Can you think of a complaint you have aimed at your partner that you can turn into an assertive, empathic request?

*Gottman, John M.; Krokoff, Lowell J., Marital interaction and satisfaction: A longitudinal view. Journal of Consulting and Clinical Psychology, Vol 57(1), Feb 1989, 47-52. doi:10.1037/0022-006X.57.1.47